Postgraduate Orthodontics Students' and Mentors' Perceptions of Portfolios and Discussion as Tools for Development of Reflection.

Science.gov (United States)

Tonni, Ingrid; Mora, Luca; Oliver, Richard G

2016-09-01

The aim of this study was to analyze the effects of a portfolio learning strategy designed to develop students' reflection abilities in a postgraduate orthodontic program in the UK. Nine first-year postgraduate orthodontic students and seven mentors participated in the one-year program, which included a reflective portfolio, mentorship, and discussion. After the program, the students' and mentors' perceptions were collected using focus groups and individual interviews, respectively. The data were analyzed using thematic analysis. Four categories emerged. The first, reflection, was considered a skill to learn, and time was needed for students to fully understand its meaning and achieve its outcomes. The second theme, characteristics of reflection, was descriptive at the beginning and more critical at the end of the experience. The third theme, outcomes of reflection, involved students' improved problem-solving and action-planning abilities and increased self-awareness, motivation, confidence, and communication skills. In the fourth theme, stimulation of reflection, students did not agree with mentors regarding the importance of reflective writing, but they recognized the value of the portfolio's reflective log in facilitating the reflective process. There was greater agreement between students and mentors regarding discussions with mentors and among peers as tools to achieve higher levels of reflection. Overall, these students and mentors considered the strategy an effective tool for improving students' reflection.

Insight in Schizophrenia: Involvement of Self-Reflection Networks?

Science.gov (United States)

de Vos, Annerieke E.

2013-01-01

Background: Impaired insight is a common feature in psychosis and an important predictor of variables such as functional outcome, prognosis, and treatment adherence. A cognitive process that may underlie insight in psychosis is self-reflection, or the conscious evaluation of one’s traits and characteristics. The current study aims to investigate the neural correlates of self-reflective processing and its relationship with insight in schizophrenia. Methods: Forty-seven schizophrenia patients and 21 healthy controls performed a self-reflection task in a functional magnetic resonance imaging (fMRI) scanner. The tasks comprised a self-reflection, close other-reflection, and a semantic (baseline) condition. Insight scores were obtained with the Schedule of Assessment of Insight Expanded. In addition, cognitive insight scores were obtained (Beck Cognitive Insight Scale [BCIS]). Results: Schizophrenia patients demonstrated less activation in the posterior cingulate cortex in the self- and other-reflection conditions and less activation in the precuneus in the other-reflection condition compared with healthy controls. Better insight was associated with greater response in the inferior frontal gyrus, anterior insula, and inferior parietal lobule during self-reflection. In addition, better cognitive insight was associated with higher activation in ventromedial prefrontal cortex during self-reflection. Conclusion: In the current study, evidence for a relationship between self-reflection and insight in patients with schizophrenia was found in brain areas related to self-reflection, self/other distinction and source attribution. The findings support the rationale for a treatment that is currently under evaluation, which attempts to increase insight by enhancing self-reflection. PMID:23104865

Water Exploitation and Its Outcomes Caused by Capitalism as Reflected on Gore Verbinski's Rango Movie

OpenAIRE

SETIAWAN, DANIEL NUGRAHA

2014-01-01

Nugraha Setiawan, Daniel. 2014. Water Exploitation and Its Outcome Caused byCapitalism as Reflected on Gore Verbinski's Rango Movie. Study Program ofEnglish, Universitas Brawijaya.Supervisor: Yusri Fajar, Co-supervisor: Melania Shinta Harendika.Keywords: water exploitation, environment, capitalism, Rango movie. Water exploitation threats ecosystem and causes a great damage to environment. One of the causes of the water exploitation is capitalism. The movie entitled Rango reveals some causes a...

Elevated outcome-anticipation and outcome-evaluation ERPs associated with a greater preference for larger-but-delayed rewards.

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Pornpattananangkul, Narun; Nadig, Ajay; Heidinger, Storm; Walden, Keegan; Nusslock, Robin

2017-06-01

Although waiting for a reward reduces or discounts its value, some people have a stronger tendency to wait for larger rewards and forgo smaller-but-immediate rewards. This ability to delay gratification is captured by individual differences in so-called intertemporal choices in which individuals are asked to choose between larger-but-delayed versus smaller-but-immediate rewards. The current study used event-related potentials (ERPs) to examine whether enhancement in two neurocognitive processes, outcome anticipation and outcome evaluation, modulate individual variability in intertemporal responses. After completing a behavioral intertemporal choice task, 34 participants performed an ERP gambling task. From this ERP task, we separately examined individual differences in outcome anticipation (stimulus-preceding negativity; SPN), early outcome valuation (feedback-related negativity; FRN), and late outcome evaluation (P3). We observed that both elevated outcome-anticipation (SPN) and late outcome-evaluation (P3) neural processes predicted a stronger preference toward larger-but-delayed rewards. No relationship was observed between intertemporal responses and early outcome evaluation (FRN), indicating that the relationship between outcome evaluation and intertemporal responses was specific to the late outcome-evaluation processing stream. Moreover, multiple regression analyses indicated that the SPN and P3 independently modulate individual differences in intertemporal responses, suggesting separate mechanisms underlie the relationship between these two neurocognitive processes and intertemporal responses. Accordingly, we identify two potential neurocognitive modulators of individual variability in intertemporal responses. We discuss the mechanisms underlying these modulators in terms of anticipation-related processing (SPN) and a saliency bias toward gain (compared to loss) outcomes (P3).

Reported positive and negative outcomes associated with a self-practice/self-reflection cognitive-behavioural therapy exercise for CBT trainees.

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Spendelow, Jason S; Butler, Lisa J

2016-09-01

The aim of the current study was to identify outcomes of a self-practice/self-reflection (SP/SR) exercise for trainee clinical psychologists. Thirty-two trainees enrolled in their first year of a UK university doctoral clinical psychology training programme completed an online questionnaire following an eight-week exercise. Findings indicated an endorsement of many previously reported benefits of exercise participation, but also the identification of negative outcomes. Thematic analysis of qualitative data revealed that outcomes could be grouped into two main thematic domains (individual task outcomes and task organization issues) along with several subordinate themes. SP/SR is a useful tool in the development of trainee CBT therapist competences. There has been limited previous recognition of potential negative outcomes from this type of exercise. However, these can provide additional impetus for therapist skill development.

Reflecting on reflection in interprofessional education: implications for theory and practice.

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Clark, Phillip G

2009-05-01

Interprofessional education (IPE) involves learning, and learning requires reflection. Educators need to "reflect more on reflection" if they are to be effective teachers in ensuring the learning outcomes essential for teamwork and interprofessional practice (IPP), including incorporating both theory and practice into the development of educational interventions. First, this discussion surveys the IPE-relevant literature on reflection, and then defines and refines the multidimensional concept of reflection as it relates to IPE in developing and implementing teamwork learning programs and experiences. Second, specific methods to promote reflection are presented and explored, including self-assessments, journaling, and written papers. Actual samples from student journals and assignments provide examples of the impacts of using these methods on participant reflection and learning. Finally, implications for an expanded understanding and application of reflection for IPE will be discussed, and recommendations made for educational practice and research in this area.

Stigma, Reflected Appraisals, and Recovery Outcomes in Mental Illness

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Markowitz, Fred E.; Angell, Beth; Greenberg, Jan S.

2011-01-01

Drawing on modified labeling theory and the reflected appraisals process and using longitudinal data from 129 mothers and their adult children with schizophrenia, we estimate models of the effects of mothers' stigmatized identity appraisals of their mentally ill children on reflected and self-appraisals, and how appraisals affect outcomes…

Patient expectations predict greater pain relief with joint arthroplasty.

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Gandhi, Rajiv; Davey, John Roderick; Mahomed, Nizar

2009-08-01

We examined the relationship between patient expectations of total joint arthroplasty and functional outcomes. We surveyed 1799 patients undergoing primary hip or knee arthroplasty for demographic data and Western Ontario McMaster University Osteoarthritis Index scores at baseline, 3 months, and 1 year of follow-up. Patient expectations were determined with 3 survey questions. The patients with the greatest expectations of surgery were younger, male, and had a lower body mass index. Linear regression modeling showed that a greater expectation of pain relief with surgery independently predicted greater reported pain relief at 1 year of follow-up, adjusted for all relevant covariates (P relief after joint arthroplasty is an important predictor of outcomes at 1 year.

Reflections on Asia: Borrowing Lessons from the Humanities in Social Science Coursework

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Howard Sanborn

2017-07-01

Full Text Available What lessons can political science classes borrow from the humanities? This paper presents the results of a multi-year study on teaching about Asia as part of a general education program. Given the challenges of meeting common learning outcomes while also teaching discipline-specific lessons, political science courses often underperformed in assessments when compared to benchmark expectations. While our initial conclusion—that a greater focus on multimodal assignments would promote deeper learning and reflection—proved unfounded, explicitly emphasizing students’ reflection on their own process of democratic engagement, in comparison to that of their counterparts in Asia, did seem to address the shortcomings of the previous approaches by giving students context and guidance in their understanding of how democracy works at home and abroad. Data from reflective essays, collected over two years, provide evidence for this finding.

Change in drawing placement: A measure of change in mood state reflective of hemispheric lateralization of emotion.

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Butler, Tracy R; O'Mara, Erin M; Wilson, Josephine F

2018-04-26

The Valence Hypothesis of cerebral lateralization of emotion suggests greater right hemisphere activation during negative mood and greater left hemisphere activation during positive mood. This can manifest as visual field attentional bias. Here, study participants completed an assessment of current mood state (PANAS) and made a drawing (Drawing 1). To induce positive or negative mood, participants played a game; then, the winner read a script depicting a positive interpersonal interaction and the loser read a script depicting a negative interpersonal interaction. Participants then drew a second picture (Drawing 2) and completed the PANAS. We hypothesized that the game outcome would change current mood state and hemispheric activation, which would be reflected in drawing placement. The placement of Drawing 2 moved right for winners and left for losers. Winners experienced a greater increase in positive affect from Time 1 to Time 2 than losers and had decreased negative affect from Time 1. Losers had decreased positive affect from Time 1 and had a greater increase in negative affect from Time 1 to Time 2 than winners. Our results suggest that change in current mood state may be objectively observed by evaluating hemispatial bias reflective of brain hemispheric activation with drawings. Copyright © 2018 Elsevier Inc. All rights reserved.

International Society for Quality of Life Research commentary on the draft European Medicines Agency reflection paper on the use of patient-reported outcome (PRO) measures in oncology studies.

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Kyte, Derek; Reeve, Bryce B; Efficace, Fabio; Haywood, Kirstie; Mercieca-Bebber, Rebecca; King, Madeleine T; Norquist, Josephine M; Lenderking, William R; Snyder, Claire; Ring, Lena; Velikova, Galina; Calvert, Melanie

2016-02-01

In 2014, the European Medicines Agency (EMA) released for comment a draft reflection paper on the use of patient-reported outcome (PRO) measures in oncology studies. A twelve-member International Society for Quality of Life Research (ISOQOL) taskforce was convened to coordinate the ISOQOL response. Twenty-one ISOQOL members provided detailed comments and suggestions on the paper: 81 % from academia and 19 % from industry. Taskforce members consolidated and further refined these comments and shared the recommendations with the wider ISOQOL membership. A final response was submitted to the EMA in November 2014. The impending publication of the EMA reflection paper presents a valuable opportunity for ISOQOL to comment on the current direction of EMA PRO guidance and strategy. The EMA paper, although focused on cancer, could serve as a model for using PROs in other conditions, as it provides a useful update surrounding some of the design issues common to all trial research including PRO endpoints. However, we believe there are a number of additional areas in need of greater consideration. The purpose of this commentary is therefore to highlight the strengths of this timely and potentially useful document, but also to outline areas that may warrant further discussion.

Liver Stiffness Reflecting Right-Sided Filling Pressure Can Predict Adverse Outcomes in Patients With Heart Failure.

Science.gov (United States)

Taniguchi, Tatsunori; Ohtani, Tomohito; Kioka, Hidetaka; Tsukamoto, Yasumasa; Onishi, Toshinari; Nakamoto, Kei; Katsimichas, Themistoklis; Sengoku, Kaoruko; Chimura, Misato; Hashimoto, Haruko; Yamaguchi, Osamu; Sawa, Yoshiki; Sakata, Yasushi

2018-01-12

This study sought to investigate whether elevated liver stiffness (LS) values at discharge reflect residual liver congestion and are associated with worse outcomes in patients with heart failure (HF). Transient elastography is a newly developed, noninvasive method for assessing LS, which can be highly reflective of right-sided filling pressure associated with passive liver congestion in patients with HF. LS values were determined for 171 hospitalized patients with HF before discharge using a Fibroscan device. The median LS value was 5.6 kPa (interquartile range: 4.4 to 8.1; range 2.4 to 39.7) and that of right-sided filling pressure, which was estimated based on LS, was 5.7 mm Hg (interquartile range: 4.1 to 8.2 mm Hg; range 0.1 to 18.9 mm Hg). The patients in the highest LS tertile (>6.9 kPa, corresponding to an estimated right-sided filling pressure of >7.1 mm Hg) had advanced New York Heart Association functional class, high prevalence of jugular venous distention and moderate/severe tricuspid regurgitation, large inferior vena cava (IVC) diameter, low hemoglobin and hematocrit levels, high serum direct bilirubin level, and a similar left ventricular ejection fraction compared with the lower tertiles. During follow-up periods (median: 203 days), 8 (5%) deaths and 33 (19%) hospitalizations for HF were observed. The patients in the highest LS group had a significantly higher mortality rate and HF rehospitalization (hazard ratio: 3.57; 95% confidence interval: 1.93 to 6.83; p direct bilirubin and brain natriuretic peptide levels, LS values were predictive of worse outcomes, even after adjustment for these indices. These data suggest that LS is a useful index for assessing systemic volume status and predicting the severity of HF, and that the presence of liver congestion at discharge is associated with worse outcomes in patients with HF. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Electrophysiological Correlates of Cue-Related Processing in a Gambling Task: Early Outcome Evaluation or Outcome Expectation?

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Xiaoyi Zhang

2017-06-01

Full Text Available Several recent studies have suggested that cues that predict outcomes elicit a feedback-related-like negativity (FRN-like negativity reflecting initial appraisals of whether desired outcomes are probable. Some other studies, however, have found that the cues that predict outcomes elicited event-related potentials (ERPs that reflect the expectation to outcomes (e.g., outcome expectations. Given these mixed findings, this study aimed to examine whether the brain activity elicited by predictive cues in a gambling task reflected the initial evaluations of the outcomes, the outcome expectations, or both. We used a gambling task in which the participants were told to guess which of two doors hid a reward. At the beginning of each trial, a cue was presented to inform the participants of how many doors hid a reward. We found that these predictive cues elicited a FRN-like negativity at the frontal sites within around 200–300 ms. However, this negativity did not significantly differ between the cues that fully predicted gains and the cues that fully predicted losses. Furthermore, predictive cues elicited an expectation-related slow wave, and cues that predicted gains with a 50% probability elicited a larger expectation-related slow wave than cues that fully predicted gains or losses. Our results suggest that cues predicting outcomes reflect outcome expectations rather than initial evaluations of the forthcoming outcomes.

Socio-economic considerations of cleaning Greater Vancouver's air

International Nuclear Information System (INIS)

2005-08-01

Socio-economic considerations of better air quality on the Greater Vancouver population and economy were discussed. The purpose of the study was to provide socio-economic information to staff and stakeholders of the Greater Vancouver Regional District (GVRD) who are participating in an Air Quality Management Plan (AQMP) development process and the Sustainable Region Initiative (SRI) process. The study incorporated the following methodologies: identification and review of Canadian, American, and European quantitative socio-economic, cost-benefit, cost effectiveness, competitiveness and health analyses of changes in air quality and measures to improve air quality; interviews with industry representatives in Greater Vancouver on competitiveness impacts of air quality changes and ways to improve air quality; and a qualitative analysis and discussion of secondary quantitative information that identifies and evaluates socio-economic impacts arising from changes in Greater Vancouver air quality. The study concluded that for the Greater Vancouver area, the qualitative analysis of an improvement in Greater Vancouver air quality shows positive socio-economic outcomes, as high positive economic efficiency impacts are expected along with good social quality of life impacts. 149 refs., 30 tabs., 6 appendices

‘Utilitarian’ judgments in sacrificial moral dilemmas do not reflect impartial concern for the greater good

OpenAIRE

Kahane, Guy; Everett, Jim A.C.; Earp, Brian D.; Farias, Miguel; Savulescu, Julian

2015-01-01

A growing body of research has focused on so-called ?utilitarian? judgments in moral dilemmas in which participants have to choose whether to sacrifice one person in order to save the lives of a greater number. However, the relation between such ?utilitarian? judgments and genuine utilitarian impartial concern for the greater good remains unclear. Across four studies, we investigated the relationship between ?utilitarian? judgment in such sacrificial dilemmas and a range of traits, attitudes,...

Cognitive Reflection Versus Calculation in Decision Making

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Aleksandr eSinayev

2015-05-01

Full Text Available Scores on the three-item Cognitive Reflection Test (CRT have been linked with dual-system theory and normative decision making (Frederick, 2005. In particular, the CRT is thought to measure monitoring of System 1 intuitions such that, if cognitive reflection is high enough, intuitive errors will be detected and the problem will be solved. However, CRT items also require numeric ability to be answered correctly and it is unclear how much numeric ability vs. cognitive reflection contributes to better decision making. In two studies, CRT responses were used to calculate Cognitive Reflection and numeric ability; a numeracy scale was also administered. Numeric ability, measured on the CRT or the numeracy scale, accounted for the CRT’s ability to predict more normative decisions (a subscale of decision-making competence, incentivized measures of impatient and risk-averse choice, and self-reported financial outcomes; Cognitive Reflection contributed no independent predictive power. Results were similar whether the two abilities were modeled (Study 1 or calculated using proportions (Studies 1 and 2. These findings demonstrate numeric ability as a robust predictor of superior decision making across multiple tasks and outcomes. They also indicate that correlations of decision performance with the CRT are insufficient evidence to implicate overriding intuitions in the decision-making biases and outcomes we examined. Numeric ability appears to be the key mechanism instead.

Cognitive reflection vs. calculation in decision making.

Science.gov (United States)

Sinayev, Aleksandr; Peters, Ellen

2015-01-01

Scores on the three-item Cognitive Reflection Test (CRT) have been linked with dual-system theory and normative decision making (Frederick, 2005). In particular, the CRT is thought to measure monitoring of System 1 intuitions such that, if cognitive reflection is high enough, intuitive errors will be detected and the problem will be solved. However, CRT items also require numeric ability to be answered correctly and it is unclear how much numeric ability vs. cognitive reflection contributes to better decision making. In two studies, CRT responses were used to calculate Cognitive Reflection and numeric ability; a numeracy scale was also administered. Numeric ability, measured on the CRT or the numeracy scale, accounted for the CRT's ability to predict more normative decisions (a subscale of decision-making competence, incentivized measures of impatient and risk-averse choice, and self-reported financial outcomes); Cognitive Reflection contributed no independent predictive power. Results were similar whether the two abilities were modeled (Study 1) or calculated using proportions (Studies 1 and 2). These findings demonstrate numeric ability as a robust predictor of superior decision making across multiple tasks and outcomes. They also indicate that correlations of decision performance with the CRT are insufficient evidence to implicate overriding intuitions in the decision-making biases and outcomes we examined. Numeric ability appears to be the key mechanism instead.

Workplace Congruence and Occupational Outcomes among Social Service Workers.

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Graham, John R; Shier, Micheal L; Nicholas, David

2016-06-01

Workplace expectations reflect an important consideration in employee experience. A higher prevalence of workplace congruence between worker and employer expectations has been associated with higher levels of productivity and overall workplace satisfaction across multiple occupational groups. Little research has investigated the relationship between workplace congruence and occupational health outcomes among social service workers. This study sought to better understand the extent to which occupational congruence contributes to occupational outcomes by surveying unionised social service workers ( n = 674) employed with the Government of Alberta, Canada. Multiple regression analysis shows that greater congruence between workplace and worker expectations around workloads, workplace values and the quality of the work environment significantly: (i) decreases symptoms related to distress and secondary traumatic stress; (ii) decreases intentions to leave; and (iii) increases overall life satisfaction. The findings provide some evidence of areas within the workplace of large government run social welfare programmes that can be better aligned to worker expectations to improve occupational outcomes among social service workers.

Perceptions of the use of reflective learning journals in online graduate nursing education.

Science.gov (United States)

Langley, Malinda E; Brown, Sylvia T

2010-01-01

The purpose of this study was to examine the perceptions of graduate nursing students and a small sample of faculty regarding learning outcomes associated with reflective learning journals (RLJ) in online education. Reflective journaling is used extensively in nursing curricula, yet few studies have explored perceptions of learning outcomes with online students, specifically those preparing to become nurse educators.An electronic survey was developed utilizing items associated with four learning outcomes of reflective journaling: professional development, personal growth, empowerment, and facilitation of the learning process. Positive outcomes such as the connection between theory and practice, recognition of strengths and weaknesses, and integration of new ideas and concepts were identified. Obstacles included the amount of time needed for reflection and grading, and the development of trust between students and faculty. The results of this study indicate that graduate students and faculty perceive positive learning outcomes with the use of reflective journals in online education.

Introduction. China and the Challenges in Greater Middle East

DEFF Research Database (Denmark)

Sørensen, Camilla T. N.; Andersen, Lars Erslev; Jiang, Yang

2016-01-01

This collection of short papers is an outcome of an international conference entitled China and the Challenges in Greater Middle East, organized by the Danish Institute for International Studies and Copenhagen University on 10 November 2015. The conference sought answers to the following questions...

Greater trochanteric fracture with occult intertrochanteric extension.

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Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph

2013-10-01

Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.

Frustrated Total Internal Reflection: A Simple Application and Demonstration.

Science.gov (United States)

Zanella, F. P.; Magalhaes, D. V.; Oliveira, M. M.; Bianchi, R. F.; Misoguti, L.; Mendonca, C. R.

2003-01-01

Describes the total internal reflection process that occurs when the internal angle of incidence is equal to or greater than the critical angle. Presents a demonstration of the effect of frustrated total internal reflection (FTIR). (YDS)

A systematic review of team formulation in clinical psychology practice: Definition, implementation, and outcomes.

Science.gov (United States)

Geach, Nicole; Moghaddam, Nima G; De Boos, Danielle

2017-10-03

Team formulation is promoted by professional practice guidelines for clinical psychologists. However, it is unclear whether team formulation is understood/implemented in consistent ways - or whether there is outcome evidence to support the promotion of this practice. This systematic review aimed to (1) synthesize how team formulation practice is defined and implemented by practitioner psychologists and (2) analyse the range of team formulation outcomes in the peer-reviewed literature. Seven electronic bibliographic databases were searched in June 2016. Eleven articles met inclusion criteria and were quality assessed. Extracted data were synthesized using content analysis. Descriptions of team formulation revealed three main forms of instantiation: (1) a structured, consultation approach; (2) semi-structured, reflective practice meetings; and (3) unstructured/informal sharing of ideas through routine interactions. Outcome evidence linked team formulation to a range of outcomes for staff teams and service users, including some negative outcomes. Quality appraisal identified significant issues with evaluation methods; such that, overall, outcomes were not well-supported. There is weak evidence to support the claimed beneficial outcomes of team formulation in practice. There is a need for greater specification and standardization of 'team formulation' practices, to enable a clearer understanding of any relationships with outcomes and implications for best-practice implementations. Under the umbrella term of 'team formulation', three types of practice are reported: (1) highly structured consultation; (2) reflective practice meetings; and (3) informal sharing of ideas. Outcomes linked to team formulation, including some negative outcomes, were not well evidenced. Research using robust study designs is required to investigate the process and outcomes of team formulation practice. © 2017 The British Psychological Society.

Feedback-related negativity codes outcome valence, but not outcome expectancy, during reversal learning.

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von Borries, A K L; Verkes, R J; Bulten, B H; Cools, R; de Bruijn, E R A

2013-12-01

Optimal behavior depends on the ability to assess the predictive value of events and to adjust behavior accordingly. Outcome processing can be studied by using its electrophysiological signatures--that is, the feedback-related negativity (FRN) and the P300. A prominent reinforcement-learning model predicts an FRN on negative prediction errors, as well as implying a role for the FRN in learning and the adaptation of behavior. However, these predictions have recently been challenged. Notably, studies so far have used tasks in which the outcomes have been contingent on the response. In these paradigms, the need to adapt behavioral responses is present only for negative, not for positive feedback. The goal of the present study was to investigate the effects of positive as well as negative violations of expectancy on FRN amplitudes, without the usual confound of behavioral adjustments. A reversal-learning task was employed in which outcome value and outcome expectancy were orthogonalized; that is, both positive and negative outcomes were equally unexpected. The results revealed a double dissociation, with effects of valence but not expectancy on the FRN and, conversely, effects of expectancy but not valence on the P300. While FRN amplitudes were largest for negative-outcome trials, irrespective of outcome expectancy, P300 amplitudes were largest for unexpected-outcome trials, irrespective of outcome valence. These FRN effects were interpreted to reflect an evaluation along a good-bad dimension, rather than reflecting a negative prediction error or a role in behavioral adaptation. By contrast, the P300 reflects the updating of information relevant for behavior in a changing context.

Learning Through Reflective Writing: A Teaching Strategy. A Review of: Sen, B. A. (2010. Reflective writing: A management skill. Library Management, 31(1/2, 79-93.

Directory of Open Access Journals (Sweden)

Kristen L. Young

2010-12-01

Full Text Available Objective – To explore student thought on both reflection and reflective writing as a process, and to analyze the writing by the application of clearly defined and identifiable outcomes.Design – Mixed method approach consisting of a qualitative analysis of 116 written reflections from master’s level students as well as a quantitative statistical analysis.Setting –The University of Sheffield masters-level librarianship program’s course INF6005, “Management for LIS.”Subjects – Of the 31 students registered the course during the 2007-2008 academic year, 22 (71%, allowed their reflections to be used for the purposes of research. Of these, 7 students identified themselves as male, and 15 were female. All students included were over 21 years of age and had previous library experience, with varying degrees of management experience in supervisory roles. Not all supervisory experience was gathered within the library domain.Methods –A total of 116 reflective journal entries were submitted by the participating students during the eight month period from October 2008 to May 2009. In order to identify themes, qualitative analysis was applied to the reflective writing responses. Descriptive statistics were also applied to test the hypothesis, illustrate the relationships between reflective writing and outcomes, and locate identifiable outcomes.Main Results – Practising reflection demonstrated benefits for individuals groups both in and outside of the workplace. On the whole, individuals gained the most from reflection and saw it in the most positive light when it was practised as a daily activity. Quantitatively, when students began to master the practice of reflection, they demonstrated an increase in their ability to learn and an overall improvement of self-development and critical thinking skills, and gained a defined awareness of personal mental function. When decision making became easier, students understood they had begun to master

Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes.

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Muhammad, Michael; Wallerstein, Nina; Sussman, Andrew L; Avila, Magdalena; Belone, Lorenda; Duran, Bonnie

2015-11-01

The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team's processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team's self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR.

Reflection as a Learning Tool in Graduate Medical Education: A Systematic Review.

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Winkel, Abigail Ford; Yingling, Sandra; Jones, Aubrie-Ann; Nicholson, Joey

2017-08-01

Graduate medical education programs employ reflection to advance a range of outcomes for physicians in training. However, the most effective applications of this tool have not been fully explored. A systematic review of the literature examined interventions reporting the use of reflection in graduate medical education. The authors searched Medline/PubMed, Embase, Cochrane CENTRAL, and ERIC for studies of reflection as a teaching tool to develop medical trainees' capacities. Key words and subject headings included reflection , narrative , residents/GME , and education / teaching / learning . No language or date limits were applied. The search yielded 1308 citations between inception for each database and June 15, 2015. A total of 16 studies, encompassing 477 residents and fellows, met eligibility criteria. Study quality was assessed using the Critical Appraisal Skills Programme Qualitative Checklist. The authors conducted a thematic analysis of the 16 articles. Outcomes studied encompassed the impact of reflection on empathy, comfort with learning in complex situations, and engagement in the learning process. Reflection increased learning of complex subjects and deepened professional values. It appears to be an effective tool for improving attitudes and comfort when exploring difficult material. Limitations include that most studies had small samples, used volunteers, and did not measure behavioral outcomes. Critical reflection is a tool that can amplify learning in residents and fellows. Added research is needed to understand how reflection can influence growth in professional capacities and patient-level outcomes in ways that can be measured.

Reflectivity and thickness analysis of epiretinal membranes using spectral-domain optical coherence tomography

Directory of Open Access Journals (Sweden)

Ajay E. Kuriyan

2016-01-01

Full Text Available AIM: To compare thickness and reflectivity spectral domain optical coherence tomography (SD-OCT findings in patients with idiopathic epiretinal membranes (ERMs, before and after ERM peeling surgery, with normal controls. METHODS: A retrospective study analyzed SD-OCTs of eyes with ERMs undergoing ERM peeling surgery by one surgeon from 2008 to 2010 and normal control eyes. SD-OCTs were analyzed using a customized algorithm to measure reflectivity and thickness. The relationship between the SD-OCT findings and best corrected visual acuity (BCVA outcomes was also studied. RESULTS: Thirty-four ERM eyes and 12 normal eyes were identified. Preoperative eyes had high reflectivity and thickness of the group of layers from the internal limiting membrane (ILM to the retinal pigment epithelium (RPE and the group of layers from the ILM to the external limiting membrane (ELM. The values of reflectivity of these two groups of layers decreased postoperatively, but were still higher than normal eyes. In contrast, preoperative eyes had lower reflectivity of two 10×15 pixel regions of interest (ROIs incorporating: 1 ELM + outer nuclear layer (ONL and 2 photoreceptor layer (PRL + RPE, compared to controls. The values of reflectivity of these ROIs increased postoperatively, but were still lower than normal controls. A larger improvement in BCVA postoperatively was correlated with a greater degree of abnormal preoperative reflectivity and thickness findings. CONCLUSION: Quantitative differences in reflectivity and thickness between preoperative, postoperative, and normal SD-OCTs allow assessment of changes in the retina secondary to ERM. Our study identified hyperreflective inner retina changes and hyporeflective outer retina changes in patients with ERMs. SD-OCT quantitative measures of reflectivity and/or thickness of specific groups of retinal layers and/or ROIs correlate with improvement in BCVA.

Assessing reflective thinking and approaches to learning.

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Dunn, Louise; Musolino, Gina M

2011-01-01

Facilitation of reflective practice is critical for the ongoing demands of health care practitioners. Reflective thinking concepts, grounded in the work of Dewey and Schön, emphasize critical reflection to promote transformation in beliefs and learning necessary for reflective practice. The Reflective Thinking Questionnaire (QRT) and Revised Study Process Questionnaire (RSPQ-2F) assess skill aspects of professional reasoning, with promise for measuring changes over time. The purpose of this study was to examine the reliability and responsiveness and the model validity of reflective thinking and approaches to learning measures for U.S. health professions students enrolled in entry-level occupational (MOT) and physical therapy (DPT) programs. This measurement study addressed reliability and responsiveness of two measures, the QRT and RSPQ-2F, for graduate health professionals. A convenience sample of 125 MOT and DPT students participated in the two-measure, test-retest investigation, with electronic data collection. Outcomes support the stability of the four-scale QRT (ICC 0.63 to 0.82) and the two-scale RSPQ-2F (ICC 0.91 and 0.87). Descriptive data supporting responsiveness are presented. With noted limitations, the results support the use of the QRT and RSPQ-2F measures to assess changes in reflective thinking and approaches to learning. Measurement of these learning outcomes furthers our understanding and knowledge about instructional strategies, development of professional reasoning, and fostering of self-directed learning within MOT and DPT programs.

Tailoring diffuse reflectance of inhomogeneous films containing microplatelets

Energy Technology Data Exchange (ETDEWEB)

Slovick, Brian A., E-mail: brian.slovick@sri.com; Baker, John M.; Flom, Zachary; Krishnamurthy, Srini [Applied Optics Laboratory, SRI International, Menlo Park, California 94025 (United States)

2015-10-05

We develop an analytical model for calculating the diffuse reflectance of inhomogeneous films containing aligned microplatelets with diameters much greater than the wavelength. The scattering parameters are derived by modeling the platelets as one-dimensional thin films, and the overall diffuse reflectance of the slab is calculated using the Kubelka-Munk model. Our model predicts that reflection minima and maxima arising from coherent interference within the platelets are preserved in the diffuse reflectance of the disordered slab. Experimental validation of the model is provided by reflectance measurements (0.3–15 μm) of a solid aerosol film of aligned hexagonal boron nitride platelets.

Reflections on Clinical Learning in Novice Speech-Language Therapy Students

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Hill, Anne E.; Davidson, Bronwyn J.; Theodoros, Deborah G.

2012-01-01

Background: Reflective practice is reported to enhance clinical reasoning and therefore to maximize client outcomes. The inclusion of targeted reflective practice in academic programmes in speech-language therapy has not been consistent, although providing opportunities for speech-language therapy students to reflect during their clinical practice…

[Who benefits from systemic therapy with a reflecting team?].

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Höger, C; Temme, M; Geiken, G

1994-03-01

In an evaluation study we investigated the effectiveness of the reflecting team approach compared to eclectic child psychiatric treatment in an outpatient setting and the indications for each type of treatment. The relationship between treatment outcome and diagnostic data obtained with the Multi-axial Classification Scheme was examined in 22 families treated with the reflecting team approach and in a second group of families matched on all important sociodemographic and diagnostic variables but receiving eclectic treatment. No difference was found between the two groups regarding symptom improvement or changes in family functioning. Regarding satisfaction with treatment, the reflecting team approach was superior to the eclectic modality. In the reflecting team group parental mental disorder and inadequate intra-familial communication (according to the new fifth axis of the Multi-axial Classification Scheme) had a negative effect on outcome.

Development of Selective Attention in Reflective and Impulsive Children.

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Weiner, Alan S.; Berzonsky, Michael D.

Selective attention was assessed in second, fourth, and sixth grade reflective and impulsive children with an incidental learning task using pictures (animal-household object pairs) or shapes (colored forms) as stimuli. By the sixth grade, reflective children displayed less incidental learning and greater central learning than impulsive children…

Clinical capabilities of graduates of an outcomes-based integrated medical program

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Scicluna Helen A

2012-06-01

Full Text Available Abstract Background The University of New South Wales (UNSW Faculty of Medicine replaced its old content-based curriculum with an innovative new 6-year undergraduate entry outcomes-based integrated program in 2004. This paper is an initial evaluation of the perceived and assessed clinical capabilities of recent graduates of the new outcomes-based integrated medical program compared to benchmarks from traditional content-based or process-based programs. Method Self-perceived capability in a range of clinical tasks and assessment of medical education as preparation for hospital practice were evaluated in recent graduates after 3 months working as junior doctors. Responses of the 2009 graduates of the UNSW’s new outcomes-based integrated medical education program were compared to those of the 2007 graduates of UNSW’s previous content-based program, to published data from other Australian medical schools, and to hospital-based supervisor evaluations of their clinical competence. Results Three months into internship, graduates from UNSW’s new outcomes-based integrated program rated themselves to have good clinical and procedural skills, with ratings that indicated significantly greater capability than graduates of the previous UNSW content-based program. New program graduates rated themselves significantly more prepared for hospital practice in the confidence (reflective practice, prevention (social aspects of health, interpersonal skills (communication, and collaboration (teamwork subscales than old program students, and significantly better or equivalent to published benchmarks of graduates from other Australian medical schools. Clinical supervisors rated new program graduates highly capable for teamwork, reflective practice and communication. Conclusions Medical students from an outcomes-based integrated program graduate with excellent self-rated and supervisor-evaluated capabilities in a range of clinically-relevant outcomes. The program

Measuring Population Health Outcomes

OpenAIRE

Parrish, R. Gibson

2010-01-01

An ideal population health outcome metric should reflect a population's dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. In contrast to these health outcomes, diseases and injuries are intermediate factors that influence the likelihood of achieving a state of health. On the basis...

Beyond lung function in COPD management: effectiveness of LABA/LAMA combination therapy on patient-centred outcomes.

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van der Molen, Thys; Cazzola, Mario

2012-03-01

Bronchodilators are central to the management of chronic obstructive pulmonary disease (COPD). Clinical studies combining different classes of bronchodilators, in particular a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist (LABA), have demonstrated greater improvements in lung function (forced expiratory volume in 1 second, FEV1) in patients with COPD than monotherapy. FEV1 has served as an important diagnostic measurement of COPD, and the majority of clinical studies of currently available pharmacotherapies grade effectiveness of treatment regimens based on improvements in FEV1. However, FEV1 alone may not adequately reflect the overall health status of the patient. Published evidence suggests that LABA/LAMA combination therapies demonstrate greater improvements in patient-centred outcomes such as dyspnoea, symptoms, rescue medication use, and quality of life than individual drugs used alone. Evaluating patient-centred outcomes associated with COPD is likely to play an important role in future research as a measure of overall treatment effectiveness. Raising awareness of the importance of outcomes beyond lung function alone, particularly in primary care where most patients initially present themselves for medical evaluation, should form a fundamental part of a more holistic approach to COPD management.

Combining administrative data feedback, reflection and action planning to engage primary care professionals in quality improvement: qualitative assessment of short term program outcomes.

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Vachon, Brigitte; Désorcy, Bruno; Gaboury, Isabelle; Camirand, Michel; Rodrigue, Jean; Quesnel, Louise; Guimond, Claude; Labelle, Martin; Huynh, Ai-Thuy; Grimshaw, Jeremy

2015-09-18

Improving primary care for chronic disease management requires a coherent, integrated approach to quality improvement. Evidence in the continuing professional development (CPD) field suggests the importance of using strategies such as feedback delivery, reflective practice and action planning to facilitate recognition of gaps and service improvement needs. Our study explored the outcomes of a CPD intervention, named the COMPAS Project, which consists of a three-hour workshop composed of three main activities: feedback, critical reflection and action planning. The feedback intervention is delivered face-to-face and presents performance indicators extracted from clinical-administrative databases. This aim of this study was to assess the short term outcomes of this intervention to engage primary care professional in continuous quality improvement (QI). In order to develop an understanding of our intervention and of its short term outcomes, a program evaluation approach was used. Ten COMPAS workshops on diabetes management were directly observed and qualitative data was collected to assess the intervention short term outcomes. Data from both sources were combined to describe the characteristics of action plans developed by professionals. Two independent coders analysed the content of these plans to assess if they promoted engagement in QI and interprofessional collaboration. During the ten workshops held, 26 interprofessional work teams were formed. Twenty-two of them developed a QI project they could implement themselves and that targeted aspects of their own practice they perceived in need of change. Most frequently prioritized strategies for change were improvement of systematic clientele follow-up, medication compliance, care pathway and support to improve adoption of healthier life habits. Twenty-one out of 22 action plans were found to target some level of improvement of interprofessional collaboration in primary care. Our study results demonstrate that the

Dissociating medial frontal and posterior cingulate activity during self-reflection.

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Johnson, Marcia K; Raye, Carol L; Mitchell, Karen J; Touryan, Sharon R; Greene, Erich J; Nolen-Hoeksema, Susan

2006-06-01

Motivationally significant agendas guide perception, thought and behaviour, helping one to define a 'self' and to regulate interactions with the environment. To investigate neural correlates of thinking about such agendas, we asked participants to think about their hopes and aspirations (promotion focus) or their duties and obligations (prevention focus) during functional magnetic resonance imaging and compared these self-reflection conditions with a distraction condition in which participants thought about non-self-relevant items. Self-reflection resulted in greater activity than distraction in dorsomedial frontal/anterior cingulate cortex and posterior cingulate cortex/precuneus, consistent with previous findings of activity in these areas during self-relevant thought. For additional medial areas, we report new evidence of a double dissociation of function between medial prefrontal/anterior cingulate cortex, which showed relatively greater activity to thinking about hopes and aspirations, and posterior cingulate cortex/precuneus, which showed relatively greater activity to thinking about duties and obligations. One possibility is that activity in medial prefrontal cortex is associated with instrumental or agentic self-reflection, whereas posterior medial cortex is associated with experiential self-reflection. Another, not necessarily mutually exclusive, possibility is that medial prefrontal cortex is associated with a more inward-directed focus, while posterior cingulate is associated with a more outward-directed, social or contextual focus.

Reflective journaling: developing an online journal for distance education.

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Kessler, Penny D; Lund, Carole H

2004-01-01

Reflective journal writing can be a useful heuristic tool to foster critical thinking skills and develop reflective clinical practice in nursing. When combined with a distance education delivery format, the online journal helps to leverage the strengths of reflective learning with educational technology as well as provide a seamless record of learning outcomes across the curriculum. The authors discuss the incorporation of an online reflective journal into a distance education clinical course and provide guidelines for educators considering a similar approach.

Thinking and writing at Masters level: a reflective passage.

Science.gov (United States)

Fowler, John

This article identifies key characteristics of Masters level writing and the underpinning relationship of these characteristics to reflective thought. Classical models of reflective writing are reviewed and their focus on reflection as a progressive process is debated. A linear model of reflection is proposed and its application to reflective writing for Masters level assessments is examined. The classical authors tend to present reflection as a process in which the outcomes of reflection becomes deeper at advanced levels. While this is an appropriate application of the concept of reflection for the traditional academic essay, it might not always be so appropriate for other more applied aspects of thinking and writing particularly in the development of advanced nursing practice. A linear model of reflective writing which offers a more pragmatic perspective on reflection is developed.

The Importance of Reflective Practice in Nursing

Directory of Open Access Journals (Sweden)

Lauren Caldwell

2013-01-01

Full Text Available Reflection is an essential attribute for the development of autonomous, critical, and advanced practitioners (Mantzoukas & Jasper, 2004. According to Chong (2009, “Reflective practice should be a continuous cycle in which experience and reflection on experiences are inter-related” (p. 112. Studies have shown that nurses who take the time to reflect on their daily experiences provide enhanced nursing care, have a better understanding of theiractions, which in return develops their professional skills (Hansebo & Kihlgren, 2001. Reflective practice is the ability to examine ones actions and experiences with the outcome of developing their practice and enhancing clinicalknowledge. Reflective practice affects all levels of nursing, from students, to advanced practice nursing students, aswell as practicing nurses. Reflective practice is an important component of the nursing curriculum. Research has shown the relationship between student nurses and their mentors is vital. In order for reflection to be effective open-mindedness, courage, and a willingness to accept, and act on, criticism must be present (Bulmam, Lathlean, & Gobbi, 2012. This paper will explore the current literature and implications related to reflective practice in nursing.

Promoting Preservice Teacher Reflectivity: Van Manen May Represent a Viable Model

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Ballard, Kristy K.; McBride, Ron

2010-01-01

From Dewey (1933) to present, reflectivity is an important component of teacher education. Little information exists that specifically addresses when changes in reflectivity might occur. Therefore, the purpose of this study was: (a) to apply Van Manen's model to outcomes to examine levels of, and changes in, reflectivity and (b) to verify the…

Particle reflection and TFTR neutral beam diagnostics

International Nuclear Information System (INIS)

Kamperschroer, J.H.; Grisham, L.R.; Kugel, H.W.; O'Connor, T.E.; Newman, R.A.; Stevenson, T.N.; von Halle, A.; Williams, M.D.

1992-04-01

Determination of two critical neutral beam parameters, power and divergence, are affected by the reflection of a fraction of the incident energy from the surface of the measuring calorimeter. On the TFTR Neutral Beam Test Stand, greater than 30% of the incident power directed at the target chamber calorimeter was unaccounted for. Most of this loss is believed due to reflection from the surface of the flat calorimeter, which was struck at a near grazing incidence (12 degrees). Beamline calorimeters, of a ''V''-shape design, while retaining the beam power, also suffer from reflection effects. Reflection, in this latter case, artificially peaks the power toward the apex of the ''V'', complicating the fitting technique, and increasing the power density on axis by 10 to 20%; an effect of import to future beamline designers. Agreement is found between measured and expected divergence values, even with 24% of the incident energy reflected

Intuition in medical practice: A reflection on Donald Schön's reflective practitioner.

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Mickleborough, Tim

2015-01-01

In a recent commentary, Dr. Abhishek Biswas asks the question whether physicians should rely on their "gut feeling" when making clinical decisions. Biswas describes a situation where his intuition resulted in an immediate course of action that prompted urgent medical attention for a patient who had "routine" pain. Inspired by the author's account, I would like to further Biswas' discussion and examine its importance using the educational theories of Donald Schön and his concept of the reflective practitioner. Schön argues that technical knowledge alone is not sufficient to solve the complex problems that professionals face on a daily basis and intuition, developed through a reflective practice, is crucial for any professional's practice, especially in a time of greater uncertainty in the workplace.

Striatal Activity and Reward Relativity: Neural Signals Encoding Dynamic Outcome Valuation.

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Webber, Emily S; Mankin, David E; Cromwell, Howard C

2016-01-01

The striatum is a key brain region involved in reward processing. Striatal activity has been linked to encoding reward magnitude and integrating diverse reward outcome information. Recent work has supported the involvement of striatum in the valuation of outcomes. The present work extends this idea by examining striatal activity during dynamic shifts in value that include different levels and directions of magnitude disparity. A novel task was used to produce diverse relative reward effects on a chain of instrumental action. Rats ( Rattus norvegicus ) were trained to respond to cues associated with specific outcomes varying by food pellet magnitude. Animals were exposed to single-outcome sessions followed by mixed-outcome sessions, and neural activity was compared among identical outcome trials from the different behavioral contexts. Results recording striatal activity show that neural responses to different task elements reflect incentive contrast as well as other relative effects that involve generalization between outcomes or possible influences of outcome variety. The activity that was most prevalent was linked to food consumption and post-food consumption periods. Relative encoding was sensitive to magnitude disparity. A within-session analysis showed strong contrast effects that were dependent upon the outcome received in the immediately preceding trial. Significantly higher numbers of responses were found in ventral striatum linked to relative outcome effects. Our results support the idea that relative value can incorporate diverse relationships, including comparisons from specific individual outcomes to general behavioral contexts. The striatum contains these diverse relative processes, possibly enabling both a higher information yield concerning value shifts and a greater behavioral flexibility.

Investigating Treatment Outcomes Across OCD Symptom Dimensions in a Clinical Sample of OCD Patients.

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Chase, Tannah; Wetterneck, Chad T; Bartsch, Robert A; Leonard, Rachel C; Riemann, Bradley C

2015-01-01

Despite the heterogeneous nature of obsessive-compulsive disorder (OCD), many self-report assessments do not adequately capture the clinical picture presenting within each symptom dimension, particularly unacceptable thoughts (UTs). In addition, obsessions and ordering/arranging compulsions are often underrepresented in samples of treatment outcome studies for OCD. Such methodological discrepancies may obscure research findings comparing treatment outcomes across OCD symptom dimensions. This study aimed to improve upon previous research by investigating treatment outcomes across OCD symptom dimensions using the Dimensional Obsessive-Compulsive Scale, which offers a more comprehensive assessment of UTs. The study included a primarily residential sample of 134 OCD patients. Results indicated that there were no significant differences in treatment outcomes across symptom dimensions. However, the severity of UTs remained significantly greater than other symptom dimensions at both admission and discharge. Thus, it is possible that UTs may exhibit uniquely impairing features, compared with other symptom dimensions. It is also possible that these findings may reflect the characteristics of the residential OCD samples. These speculations as well as implications for OCD treatment and future research are discussed.

Greater decision-making competence is associated with greater expected-value sensitivity, but not overall risk taking: an examination of concurrent validity.

Science.gov (United States)

Parker, Andrew M; Weller, Joshua A

2015-01-01

Decision-making competence reflects individual differences in the susceptibility to committing decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules). Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate processes that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC) and one such process, the degree to which individuals make choices consistent with maximizing expected value (EV). Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a) choosing risky options when EV favors those options and (b) avoiding risky options when EV favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions.

Greater decision-making competence is associated with greater expected-value sensitivity, but not overall risk taking: An examination of concurrent validity

Directory of Open Access Journals (Sweden)

Andrew M Parker

2015-05-01

Full Text Available Decision-making competence reflects individual differences in the susceptibility to decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules. Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate mechanisms that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC and one such mechanism, the degree to which individuals make choices consistent with maximizing expected value (EV. Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a choosing risky options when expected value favors those options and (b avoiding risky options when expected value favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions.

Reflective Roleplaying in the Development of Dialogic Skill

DEFF Research Database (Denmark)

Hansen, Lone Hersted

2017-01-01

Whether an organization prospers depends importantly on the relationships among its participants, and central to the success of relationships is the process of dialogue. This article describes an action-based educational practice for enhancing dialogical and relational skills among members of an ...... to the outcomes of reflective role-playing for acquiring bodily awareness, changing and expanding perspectives, developing critical self-reflection, and enhancing relational consciousness....

Reflection/suppression coatings for 900 - 1200 A radiation

Science.gov (United States)

Edelstein, Jerry

1989-01-01

The design and performance of multiple-layer, selective-reflection, selective-suppression coatings for the 900 - 1200 A band are described. These coatings are designed to optimize both high reflectivity at a desirable wavelength and low reflectivity at an undesirable wavelength. The minimum structure for a selective coating consists of a thin metal or metal oxide layer (50 - 150 A thickness) over an aluminum substrate protected with a semi-transparent dielectric (100 - 1000 A thickness). Predicted coating performance is strongly effected by varying the layer combination and thickness. A graphical method of optimizing the coating layer structure is developed. Aluminum, silicon, their oxides, and gold have been investigated as coating layer materials. A very simple coating with a 1026 to 1216 A reflectivity ratio greater than 100 was fabricated. Such reflection/suppression coatings may be of great utility to spaceborne EUV spectrographs.

Moderate Baseline Vagal Tone Predicts Greater Prosociality in Children

Science.gov (United States)

Miller, Jonas G.; Kahle, Sarah; Hastings, Paul D.

2016-01-01

Vagal tone is widely believed to be an important physiological aspect of emotion regulation and associated positive behaviors. However, there is inconsistent evidence for relations between children’s baseline vagal tone and their helpful or prosocial responses to others (Hastings & Miller, 2014). Recent work in adults suggests a quadratic association (inverted U-shape curve) between baseline vagal tone and prosociality (Kogan et al., 2014). The present research examined whether this nonlinear association was evident in children. We found consistent evidence for a quadratic relation between vagal tone and prosociality across 3 samples of children using 6 different measures. Compared to low and high vagal tone, moderate vagal tone in early childhood concurrently predicted greater self-reported prosociality (Study 1), observed empathic concern in response to the distress of others and greater generosity toward less fortunate peers (Study 2), and longitudinally predicted greater self-, mother-, and teacher-reported prosociality 5.5 years later in middle childhood (Study 3). Taken together, our findings suggest that moderate vagal tone at rest represents a physiological preparedness or tendency to engage in different forms of prosociality across different contexts. Early moderate vagal tone may reflect an optimal balance of regulation and arousal that helps prepare children to sympathize, comfort, and share with others. PMID:27819463

Reflective journaling for clinical judgment development and evaluation.

Science.gov (United States)

Lasater, Kathie; Nielsen, Ann

2009-01-01

Reflective journaling is a strategy used often in clinical education to gain insight into students' clinical thinking; however, studies indicate that students may benefit from guided reflections. Numerous tools have been used to structure student reflection with varying results. This article describes the outcomes from using the Guide for Reflection based on Tanner's Clinical Judgment Model. The Lasater Clinical Judgment Rubric, created from the Model, is used to evaluate development of clinical judgment and provides language to communicate about clinical thinking with students. Senior immersion course competencies, also developed with language from Tanner's Clinical Judgment Model,offer a comprehensive package that fosters students' clinical judgment development, faculty-student communication about clinical judgment, and evaluation of students' clinical thinking.

CABG Versus PCI: Greater Benefit in Long-Term Outcomes With Multiple Arterial Bypass Grafting.

Science.gov (United States)

Habib, Robert H; Dimitrova, Kamellia R; Badour, Sanaa A; Yammine, Maroun B; El-Hage-Sleiman, Abdul-Karim M; Hoffman, Darryl M; Geller, Charles M; Schwann, Thomas A; Tranbaugh, Robert F

2015-09-29

Treatment of multivessel coronary artery disease with traditional single-arterial coronary artery bypass graft (SA-CABG) has been associated with superior intermediate-term survival and reintervention compared with percutaneous coronary intervention (PCI) using either bare-metal stents (BMS) or drug-eluting stents (DES). This study sought to investigate longer-term outcomes including the potential added advantage of multiarterial coronary artery bypass graft (MA-CABG). We studied 8,402 single-institution, primary revascularization, multivessel coronary artery disease patients: 2,207 BMS-PCI (age 66.6 ± 11.9 years); 2,381 DES-PCI (age 65.9 ± 11.7 years); 2,289 SA-CABG (age 69.3 ± 9.0 years); and 1,525 MA-CABG (age 58.3 ± 8.7 years). Patients with myocardial infarction within 24 h, shock, or left main stents were excluded. Kaplan-Meier analysis and Cox regression were used to separately compare 9-year all-cause mortality and unplanned reintervention for BMS-PCI and DES-PCI to respective propensity-matched SA-CABG and MA-CABG cohorts. BMS-PCI was associated with worse survival than SA-CABG, especially from 0 to 7 years (p = 0.015) and to a greater extent than MA-CABG was (9-year follow-up: 76.3% vs. 86.9%; p PCI hazard ratios (HR) were as follows: versus SA-CABG, HR: 0.87; and versus MA-CABG, HR: 0.38. DES-PCI showed similar survival to SA-CABG except for a modest 0 to 3 years surgery advantage (HR: 1.06; p = 0.615). Compared with MA-CABG, DES-PCI exhibited worse survival at 5 (86.3% vs. 95.6%) and 9 (82.8% vs. 89.8%) years (HR: 0.45; p PCI for all comparisons (all p PCI or DES-PCI, resulted in substantially enhanced death and reintervention-free survival. Accordingly, MA-CABG represents the optimal therapy for multivessel coronary artery disease and should be enthusiastically adopted by multidisciplinary heart teams as the best evidence-based therapy. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Medial cortex activity, self-reflection and depression.

Science.gov (United States)

Johnson, Marcia K; Nolen-Hoeksema, Susan; Mitchell, Karen J; Levin, Yael

2009-12-01

Using functional magnetic resonance imaging, we investigated neural activity associated with self-reflection in depressed [current major depressive episode (MDE)] and healthy control participants, focusing on medial cortex areas previously shown to be associated with self-reflection. Both the MDE and healthy control groups showed greater activity in anterior medial cortex (medial frontal gyrus, anterior cingulate gyrus) when cued to think about hopes and aspirations compared with duties and obligations, and greater activity in posterior medial cortex (precuneus, posterior cingulate) when cued to think about duties and obligations (Experiment 1). However, the MDE group showed less activity than controls in the same area of medial frontal cortex when self-referential cues were more ambiguous with respect to valence (Experiment 2), and less deactivation in a non-self-referential condition in both experiments. Furthermore, individual differences in rumination were positively correlated with activity in both anterior and posterior medial cortex during non-self-referential conditions. These results provide converging evidence for a dissociation of anterior and posterior medial cortex depending on the focus of self-relevant thought. They also provide neural evidence consistent with behavioral findings that depression is associated with disruption of positively valenced thoughts in response to ambiguous cues, and difficulty disengaging from self-reflection when it is appropriate to do so.

A greater decline in female facial attractiveness during middle age reflects women’s loss of reproductive value

Directory of Open Access Journals (Sweden)

Dario eMaestripieri

2014-02-01

Full Text Available Facial attractiveness represents an important component of an individual’s overall attractiveness as a potential mating partner. Perceptions of facial attractiveness are expected to vary with age-related changes in health, reproductive value, and power. In this study, we investigated perceptions of facial attractiveness, power, and personality in two groups of women of pre- and post-menopausal ages (35-50 years and 51-65 years, respectively and two corresponding groups of men. We tested three hypotheses: 1 that perceived facial attractiveness would be lower for older than for younger men and women; 2 that the age-related reduction in facial attractiveness would be greater for women than for men; and 3 that for men, there would be a larger increase in perceived power at older ages. Eighty facial stimuli were rated by 60 (30 male, 30 female middle-aged women and men using online surveys. Our three main hypotheses were supported by the data. Consistent with sex differences in mating strategies, the greater age-related decline in female facial attractiveness was driven by male respondents, while the greater age-related increase in male perceived power was driven by female respondents. In addition, we found evidence that some personality ratings were correlated with perceived attractiveness and power ratings. The results of this study are consistent with evolutionary theory and with previous research showing that faces can provide important information about characteristics that men and women value in a potential mating partner such as their health, reproductive value, and power or possession of resources.

Reflective journal writing: how it promotes reflective thinking in clinical nursing education: a students' perspective.

Science.gov (United States)

Kok, J; Chabeli, M M

2002-08-01

According to the outcomes-based education and training system of education (OBET) in the country and the South African Nursing Council, education should focus on "creating" reflective learners and practitioners. This article seeks to determine the effectiveness of reflective journal writing in promoting the reflective thinking of learners in clinical nursing education and to validate the guidelines described in a bigger study on how to facilitate reflective thinking using reflective journal writing. A qualitative, contextual, explorative, descriptive research design was used to determine the learners' perceptions on whether reflective journal writing did promote their higher-level thinking skills during the six-month placement in a psychiatric clinical practice using the reflective diaries. From a population of seventeen fourth-year students, six volunteered to participate in a focus group interview. The data was analysed by means of the descriptive method of open coding of Tesch (in Creswell, 1994:154-156). Positive and negative results from the perceptions of the participants and a literature review served as a basis for deducing and describing guidelines for the effective use of reflective journal writing in promoting reflective thinking in clinical nursing education. The positive perception was the development of problem-solving skills attained through reflection by using analytical critical thinking, synthesis and the evaluation of situations. Self-evaluation leading to intellectual growth and self-awareness indicated a positive perception. Negative perceptions were that reflective journal writing is time consuming, content based with a lack of clear expectations from the teacher, and distrust of students about the information written. Guba's model of ensuring trustworthiness in qualitative research as described in Krefting (1991:215-222) was employed. It is concluded that reflective journal writing in clinical nursing education does promote reflective

Retinopathy of Prematurity in Neonatal Patients with Birth Weight Greater than 1500 g in Taiwan

Directory of Open Access Journals (Sweden)

Yi-Hsing Chen

2013-04-01

Full Text Available Background: To understand the characteristics, ophthalmic outcomes, and risk factors of retinopathy of prematurity (ROP in patients with birth weight (BW greater than 1500 g. The applicability of the ROP screening criteria to the Taiwanese population was also examined. Methods: The study included 104 eyes from 54 ROP patients who had BW greater than 1500 g from 1981 to 2008. Demographic information, disease courses, ophthalmic outcomes, and possible systemic risk factors were recorded. The infants were divided into groups of mild and severe ROP for a risk factor analysis. Results: The mean gestational age (GA of the infants was 31 ± 1.3 weeks, and the mean BW was 1675 ± 249 g. Mild ROP regressed in 94 eyes (90%, and 10 eyes (10% developed severe ROP. After various treatments, the regression rates for prethreshold or threshold ROP (n = 8 and stage 4 ROP (n = 2 were 100% and 50%, respectively. Forty-eight patients (85% had at least three associated systemic risk factors. A multiple logistic regression analysis revealed that patients with an intraventricular hemorrhage were found to have an increased chance of developing severe ROP, especially those with BW greater than 1500 g (p = 0.015. There was also a significant association between patients who had severe ROP and an increased risk of having cerebral palsy (CP at 1.5 years of age (p = 0.013. Conclusion: The majority of patients with BW greater than 1500 g developed mild ROP. However, advanced ROP with poor visual outcome was also encountered in some patients.

”Something that most of us do anyway”: Personal reflection and medical education

DEFF Research Database (Denmark)

Andersen, Nina Bjerre

2012-01-01

The use of reflection as a learning approach is increasing in medical education, often based on the assumption that students will not reflect without being encouraged to. Personal reflection is used to describe students’ ability to critically reflect on own learning and functioning. The assumption...... here is also that medical students seem not to reflect spontaneously. We explored students’ level of personal reflection and validated a questionnaire that attempt to measure personal reflection. We translated and adapted the Groningen Reflection Ability Scale (GRAS) to use in a Danish context...... ‘reflective’ outcomes of educational interventions....

Measuring the Effects of Self-Awareness: Construction of the Self-Awareness Outcomes Questionnaire

Directory of Open Access Journals (Sweden)

Anna Sutton

2016-11-01

Full Text Available Dispositional self-awareness is conceptualized in several different ways, including insight, reflection, rumination and mindfulness, with the latter in particular attracting extensive attention in recent research. While self-awareness is generally associated with positive psychological well-being, these different conceptualizations are also each associated with a range of unique outcomes. This two part, mixed methods study aimed to advance understanding of dispositional self-awareness by developing a questionnaire to measure its outcomes. In Study 1, expert focus groups categorized and extended an initial pool of potential items from previous research. In Study 2, these items were reduced to a 38 item self-report questionnaire with four factors representing three beneficial outcomes (reflective self-development, acceptance and proactivity and one negative outcome (costs. Regression of these outcomes against self-awareness measures revealed that self-reflection and insight predicted beneficial outcomes, rumination predicted reduced benefits and increased costs, and mindfulness predicted both increased proactivity and costs. These studies help to refine the self-awareness concept by identifying the unique outcomes associated with the concepts of self-reflection, insight, reflection, rumination and mindfulness. It can be used in future studies to evaluate and develop awareness-raising techniques to maximize self-awareness benefits while minimizing related costs.

Determinants of outcome for patients undergoing lumbar discectomy: a pilot study.

LENUS (Irish Health Repository)

Hickey, Oonagh T

2012-02-03

BACKGROUND AND OBJECTIVE: One-third of patients who undergo lumbar discectomy continue to suffer from persistent pain postoperatively. Greater preoperative warmth thresholds and greater preoperative cerebrospinal fluid concentrations of stable serum nitric oxide metabolites are associated with a worse outcome. The principal objective of this study was to examine the relationship between patient outcome (defined using the Modified Stauffer-Coventry evaluating criteria) and preoperative pain perception threshold to an electrical stimulus. METHODS: A prospective observational pilot study of patients (n = 39) was performed. Quantitative sensory testing, visual analogue scales for anxiety and pain, the Hospital Anxiety and Depression (HADS) Scale and the McGill Pain Questionnaire were completed, and serum nitric oxide metabolites were measured perioperatively. Excised disc tissue was examined histologically, and immunohistochemistry for phospholipase A2 was performed. RESULTS: Ten patients (26%) had an unsatisfactory outcome. Those with a satisfactory outcome had greater preoperative pain perception thresholds over the affected dermatome, which decreased by 2 months postoperatively. These patients also demonstrated a decrease in nitric oxide metabolites from preoperatively to 18 h postoperatively. Greater preoperative HADS scores, and greater pain intensity 4 h and 24 h postoperatively were associated with an unsatisfactory outcome. CONCLUSION: Patients with a satisfactory outcome demonstrate a decrease in pain perception thresholds and plasma concentration of stable nitric oxide metabolites during the perioperative period. Patients with an unsatisfactory outcome following lumbar discectomy experience greater preoperative anxiety and greater pain during the early postoperative period. These findings justify a larger prospective observational study.

78 FR 17643 - Greater Mississippi River Basin Water Management Board; Engineer Regulation No. 15-2-13

Science.gov (United States)

2013-03-22

... reorganized its command and control structure. This regulation revision reflects the current organizational structure and is aligned with water management activities during recent flood and drought events in the... inter- divisional coordination of water management activities within the Greater Mississippi River Basin...

Global mobility orientation and the success of self-initiated expatriates in greater China

DEFF Research Database (Denmark)

Lauring, Jakob; Selmer, Jan

2014-01-01

We investigated 640 self-initiated expatriate academics residing in Greater China. We examined whether their inherent demographic characteristics (age/gender) and acquired demographic characteristics (marital status/seniority) differentiated their work outcomes regarding job adjustment, time...... to proficiency, performance and satisfaction. We also explored the associations between global mobility orientation and these four work outcomes and examined to what extent the demographic characteristics differentiated the relationships. Results support most hypothesized differences. We found that a global...... mobility orientation was associated with all the work outcomes, except satisfaction. For inherent demographic characteristics, we found support for our hypotheses that for individuals with less successful demographics (younger, male), there was a stronger relationship between global mobility orientation...

Writing, self-reflection, and medical school performance: the Human Context of Health Care.

Science.gov (United States)

Stephens, Mark B; Reamy, Brian V; Anderson, Denise; Olsen, Cara; Hemmer, Paul A; Durning, Steven J; Auster, Simon

2012-09-01

Finding ways to improve communication and self-reflection skills is an important element of medical education and continuing professional development. This study examines the relationship between self-reflection and educational outcomes. We correlate performance in a preclinical course that focuses on self-reflection as it relates to contextual elements of patient care (Human Context of Health Care), with educational measures such as overall grade point average, clinical clerkship scores, and Medical College Admission Test (MCAT) scores. Student performance in Human Context of Health Care correlated with MCAT-Verbal scores, MCAT-writing sample scores, clerkship grades, and overall medical school grade point average (R = 0.3; p self-reflection skills are often neglected in undergraduate medical curricula. Our findings suggest that these skills are important and correlate with recognized long-term educational outcomes.

Efficacy of prophylactic splenectomy for proximal advanced gastric cancer invading greater curvature.

Science.gov (United States)

Ohkura, Yu; Haruta, Shusuke; Shindoh, Junichi; Tanaka, Tsuyoshi; Ueno, Masaki; Udagawa, Harushi

2017-05-25

For proximal gastric cancer invading the greater curvature, concomitant splenectomy is frequently performed to secure the clearance of lymph node metastases. However, prognostic impact of prophylactic splenectomy remains unclear. The aim of this study was to clarify the oncological significance of prophylactic splenectomy for advanced proximal gastric cancer invading the greater curvature. Retrospective review of 108 patients who underwent total or subtotal gastrectomy for advanced proximal gastric cancer involving the greater curvature was performed. Short-term and long-term outcomes were compared between the patients who underwent splenectomy (n = 63) and those who did not (n = 45). Patients who underwent splenectomy showed higher amount of blood loss (538 vs. 450 mL, p = 0.016) and morbidity rate (30.2 vs. 13.3, p = 0.041) compared with those who did not undergo splenectomy. In particular, pancreas-related complications were frequently observed among patients who received splenectomy (17.4 vs. 0%, p = 0.003). However, no significant improvement of long-term outcomes were confirmed in the cases with splenectomy (5-year recurrence-free rate, 60.2 vs. 67.3%; p = 0.609 and 5-year overall survival rates, 63.7 vs. 73.6%; p = 0.769). On the other hand, splenectomy was correlated with marginally better survival in patients with Borrmann type 1 or 2 gastric cancer (p = 0.072). For advanced proximal gastric cancer involving the greater curvature, prophylactic splenectomy may have no significant prognostic impact despite the increased morbidity rate after surgery. Such surgical procedure should be avoided as long as lymph node involvement is not evident.

Greater expectations: using hierarchical linear modeling to examine expectancy for treatment outcome as a predictor of treatment response.

Science.gov (United States)

Price, Matthew; Anderson, Page; Henrich, Christopher C; Rothbaum, Barbara Olasov

2008-12-01

A client's expectation that therapy will be beneficial has long been considered an important factor contributing to therapeutic outcomes, but recent empirical work examining this hypothesis has primarily yielded null findings. The present study examined the contribution of expectancies for treatment outcome to actual treatment outcome from the start of therapy through 12-month follow-up in a clinical sample of individuals (n=72) treated for fear of flying with either in vivo exposure or virtual reality exposure therapy. Using a piecewise hierarchical linear model, outcome expectancy predicted treatment gains made during therapy but not during follow-up. Compared to lower levels, higher expectations for treatment outcome yielded stronger rates of symptom reduction from the beginning to the end of treatment on 2 standardized self-report questionnaires on fear of flying. The analytic approach of the current study is one potential reason that findings contrast with prior literature. The advantages of using hierarchical linear modeling to assess interindividual differences in longitudinal data are discussed.

SA72. Neural Correlates of Self-Reflection in Schizophrenia: A Functional Magnetic Resonance Imaging Study

Science.gov (United States)

Hiremath, Chaitra; Dey, Avyarthana

2017-01-01

Abstract Background: Self-reflection is the process of conscious evaluation of one’s traits, abilities, and attitudes. Deficient self-reflective processes might underlie lack of insight into schizophrenia. The limited research literature on the neural correlates of self-reflection in schizophrenia is inconclusive. In this study, we investigated the neural correlates of self-reflection in schizophrenia patients attending a tertiary care hospital in India. Methods: Nineteen male schizophrenia patients (mean age = 32.68 ± 7.11, mean years of education =15.21 ± 1.93) and 19 male healthy controls (mean age = 26.96 ± 4.67, mean years of education = 18.11 ± 3.13) participated in the study. Participants performed a previously validated self-reflection task while undergoing functional magnetic resonance imaging (fMRI; 3-Tesla). The task comprised of 144 words subdivided into 4 domains: Self-reflection, Other-reflection, Affect labeling, and Perceptual. The task was presented as 3 runs of 8 blocks each. The images were preprocessed and analyzed using SPM-12. After preprocessing, contrasts comparing Self-reflection with the other domains were modeled at the individual subject level. In second-level analysis, the first-level contrasts were entered into a 2-sample t test to compare patient and healthy control groups. The results were thresholded at P Self-reflection > Other-reflection contrast, schizophrenia patients demonstrated greater activation of right and left superior parietal lobules (BA 5 and 7), right inferior parietal lobule (BA 39), left parahippocampal gyrus (BA 36), and left premotor cortex (BA 6). For the Self-reflection > Affect labeling contrast, patients showed greater activation of precuneus (BA 7) and right inferior occipital gyrus (BA 19), and lesser activation of left inferior frontal gyrus (BA 45 and 47). And for the Self-reflection > Perceptual contrast, patients showed greater activation of left middle frontal gyrus (BA 10

Can reflecting on personal values online increase positive beliefs about counseling?

Science.gov (United States)

Lannin, Daniel G; Vogel, David L; Heath, Patrick J

2017-04-01

This research developed and tested an online values-affirmation exercise to attenuate threat and enhance positive beliefs about counseling among individuals struggling with mental health concerns. There is evidence that reflecting on personal values (values-affirmation) is an effective approach to eliciting self-affirmation-a psychological process that temporarily bolsters self-worth in order to forestall maladaptive, self-protective responses to counseling information. The present study utilized a randomized 2-group between-subjects design to test the effectiveness of a values-affirmation exercise with an online sample (N = 186) of adults who reported struggling with a mental health concern. It was predicted that values-affirmation would reduce threat related to reading mental health information and increase positive beliefs about counseling. Results indicated that those in the values-affirmation condition reported fewer negative emotions such as feeling upset, irritable, hostile, and scared after reading mental health information, indicating that the information was perceived as less threatening. There was also evidence that engaging in values-affirmation was associated with greater anticipated growth in counseling and greater intent to seek counseling, reflecting greater positive beliefs about counseling. Overall, the results suggest that reflecting on personal values may have the potential to enhance the positive effects of online psychoeducation. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

International Education and Reflection: Transition of Swedish and American Nursing Students to Authenticity.

Science.gov (United States)

Lepp, Margret; Zorn, CeCelia R.; Duffy, Patricia R.; Dickson, Rana J.

2003-01-01

A nursing course connected U.S. and Swedish sites via interactive videoconferencing and used reflective methods (journaling, drama, photo language) and off-air group discussion. Evaluation by five Swedish and seven U.S. students suggested how reflection moved students toward greater authenticity and professionalism in nursing practice. (Contains…

Greater-than-Class C low-level waste characterization. Appendix I: Impact of concentration averaging low-level radioactive waste volume projections

International Nuclear Information System (INIS)

Tuite, P.; Tuite, K.; O'Kelley, M.; Ely, P.

1991-08-01

This study provides a quantitative framework for bounding unpackaged greater-than-Class C low-level radioactive waste types as a function of concentration averaging. The study defines the three concentration averaging scenarios that lead to base, high, and low volumetric projections; identifies those waste types that could be greater-than-Class C under the high volume, or worst case, concentration averaging scenario; and quantifies the impact of these scenarios on identified waste types relative to the base case scenario. The base volume scenario was assumed to reflect current requirements at the disposal sites as well as the regulatory views. The high volume scenario was assumed to reflect the most conservative criteria as incorporated in some compact host state requirements. The low volume scenario was assumed to reflect the 10 CFR Part 61 criteria as applicable to both shallow land burial facilities and to practices that could be employed to reduce the generation of Class C waste types

Handedness and the fringe of consciousness: strong handers ruminate while mixed handers self-reflect.

Science.gov (United States)

Niebauer, Christopher Lee

2004-12-01

Previous research found that mixed handers (i.e., those that are more ambidextrous) were more likely than strong handers to update their beliefs (Niebauer, Aselage, & Schutte, 2002). It was assumed that this was due to greater degrees of communication between the two cerebral hemispheres in mixed handers. Niebauer and Garvey (2004) made connections between this model of updating beliefs and metacognitive processing. The current work proposes that variations in interhemispheric interaction (as measured by degree of handedness) contribute to differences in consciousness, specifically when consciousness is used in rumination versus the metacognitive task of self-reflection. Using the Rumination-Reflection Questionnaire (Trapnell & Campbell, 1999), predictions were supported such that strong handedness was associated with self-rumination; whereas, mixed handedness was associated with increased self-reflection p valuesmetacognition, updating beliefs, and self-reflection. Several studies are reviewed suggesting that mixed handers experience fringe consciousness to a greater degree than strong handers.

The impact of culture on adaptive versus maladaptive self-reflection.

Science.gov (United States)

Grossmann, Igor; Kross, Ethan

2010-08-01

Although recent findings indicate that people can reflect either adaptively or maladaptively over negative experiences, extant research has not examined how culture influences this process. We compared the self-reflective practices of Russians (members of an interdependent culture characterized by a tendency to brood) and Americans (members of an independent culture in which self-reflection has been studied extensively). We predicted that self-reflection would be associated with less-detrimental outcomes among Russians because they self-distance more when analyzing their feelings than Americans do. Findings from two studies supported these predictions. In Study 1, self-reflection was associated with fewer depressive symptoms among Russians than among Americans. In Study 2, Russians displayed less distress and a more adaptive pattern of construals than Americans after reflecting over a recent negative event. In addition, they self-distanced more than Americans while analyzing their feelings, and self-distancing mediated the cultural differences in self-reflection. These findings demonstrate how culture shapes the way people reflect over negative experiences.

Insight in Schizophrenia : Involvement of Self-Reflection Networks?

NARCIS (Netherlands)

van der Meer, Lisette; de Vos, Annerieke E.; Stiekema, Annemarie P. M.; Pijnenborg, Gerdina H. M.; van Tol, Marie-Jose; Nolen, Willem A.; David, Anthony S.; Aleman, Andre

2013-01-01

Background: Impaired insight is a common feature in psychosis and an important predictor of variables such as functional outcome, prognosis, and treatment adherence. A cognitive process that may underlie insight in psychosis is self-reflection, or the conscious evaluation of one's traits and

Reflecting reflection in supervision

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

associated with reflection and an exploration of alternative conceptions that view reflection within the context of settings which have a more group- and team-based orientation. Drawing on an action research project on health care supervision, the paper questions whether we should reject earlier views...... of reflection, rehabilitate them in order to capture broader connotations or move to new ways of regarding reflection that are more in keeping with not only reflective but also emotive, normative and formative views on supervision. The paper presents a critical perspective on supervision that challenge...... the current reflective paradigm I supervision and relate this to emotive, normative and formative views supervision. The paper is relevant for Nordic educational research into the supervision and guidance...

Functional visual fields: a cross-sectional UK study to determine which visual field paradigms best reflect difficulty with mobility function.

Science.gov (United States)

Subhi, Hikmat; Latham, Keziah; Myint, Joy; Crossland, Michael

2017-11-20

To develop an appropriate method of assessing visual field (VF) loss which reflects its functional consequences, this study aims to determine which method(s) of assessing VF best reflect mobility difficulty. This cross-sectional observational study took place within a single primary care setting. Participants attended a single session at a University Eye Clinic, Cambridge, UK, with data collected by a single researcher (HS), a qualified optometrist. 50 adult participants with peripheral field impairment were recruited for this study. Individuals with conditions not primarily affecting peripheral visual function, such as macular degeneration, were excluded from the study. Participants undertook three custom and one standard binocular VF tests assessing VF to 60°, and also integrated monocular threshold 24-2 visual fields (IVF). Primary VF outcomes were average mean threshold, percentage of stimuli seen and VF area. VF outcomes were compared with self-reported mobility function assessed with the Independent Mobility Questionnaire, and time taken and patient acceptability were also considered. Receiver operating characteristic (ROC) curves determined which tests best predicted difficulty with mobility tasks. Greater VF loss was associated with greater self-reported mobility difficulty with all field paradigms (R 2 0.38-0.48, all Pmobility tasks in ROC analysis. Mean duration of the tests ranged from 1 min 26 s (±9 s) for kinetic assessment to 9 min 23 s (±24 s) for IVF. The binocular VF tests extending to 60° eccentricity all relate similarly to self-reported mobility function, and slightly better than integrated monocular VFs. A kinetic assessment of VF area is quicker than and as effective at predicting mobility function as static threshold assessment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A four-phase strategy for the implementation of reflectance confocal microscopy in dermatology

NARCIS (Netherlands)

Hoogedoorn, L.; Gerritsen, M.J.P.; Wolberink, E.A.W.; Peppelman, M.; Kerkhof, P.C.M. van de; Erp, P.E.J. van

2016-01-01

BACKGROUND: Reflectance confocal microscopy (RCM) is gradually implemented in dermatology. Strategies for further implementation and practical 'hands on' guidelines are lacking. OBJECTIVE: The primary outcome was to conduct a general strategy for further implementation of RCM. The secondary outcome

Airway complications have a greater impact on the outcomes of living-donor lobar lung transplantation recipients than cadaveric lung transplantation recipients.

Science.gov (United States)

Sugimoto, Seiichiro; Yamane, Masaomi; Otani, Shinji; Kurosaki, Takeshi; Okahara, Shuji; Hikasa, Yukiko; Toyooka, Shinichi; Kobayashi, Motomu; Oto, Takahiro

2018-04-21

Airway complications (ACs) after living-donor lobar lung transplantation (LDLLT) could have different features from those after cadaveric lung transplantation (CLT). We conducted this study to compare the characteristics of ACs after LDLLT vs. those after CLT and investigate their impact on outcomes. We reviewed, retrospectively, data on 163 recipients of lung transplantation, including 83 recipients of LDLLT and 80 recipients of CLT. The incidence of ACs did not differ between LDLLT and CLT. The initial type of AC after LDLLT was limited to stenosis in all eight patients, whereas that after CLT consisted of stenosis in three patients and necrosis in ten patients (p = 0.0034). ACs after LDLLT necessitated significantly earlier initiation of treatment than those after CLT (p = 0.032). The overall survival rate of LDLLT recipients with an AC was significantly lower than that of those without an AC (p = 0.030), whereas the overall survival rate was comparable between CLT recipients with and those without ACs (p = 0.25). ACs after LDLLT, limited to bronchial stenosis, require significantly earlier treatment and have a greater adverse impact on survival than ACs after CLT.

Low-dose external beam radiotherapy for greater trochanteric pain syndrome. Target volume definition and treatment outcome

International Nuclear Information System (INIS)

Kaltenborn, Alexander; Carl, Ulrich Martin; Hinsche, Tanja; Nitsche, Mirko; Hermann, Robert Michael

2017-01-01

Low-dose external beam radiotherapy (ED-EBRT) is frequently used in the therapy of refractory greater trochanteric pain syndrome (GTPS). As studies reporting treatment results are scarce, we retrospectively analyzed our own patient collectives. In all, 60 patients (74 hips) received LD-EBRT (6 x 0.5 Gy in 29 hips, 6 x 1 Gy in 45). The endpoint was the patient's reported subjective response to treatment. The influence of different patient and treatment characteristics on treatment outcome was investigated. At the end of LD-EBRT, 69% reported partial remission, 4% complete remission, no change 28%. A total of 3 months later (n = 52 hips), the results were 37, 33, and 30% and 18 months after LD-EBRT (n = 47) 21, 51, and 28%. In univariate analysis ''inclusion of the total femoral head into the PTV'' and ''night pain before LD-EBRT'' were correlated with symptom remission at the end of LD-EBRT, while ''initial increase in pain during LD-EBRT'' was significantly associated with treatment failure. In multivariable modeling ''initial increase in pain'' was identified as a risk factor for treatment failure (p = 0.007; odds ratio [OR] 0.209; 95% confidence interval [CI] 0.048-0.957), while ''night pain'' was an independent factor for remission (p = 0.038; OR 3.484; 95% CI 1.004-12.6). Three months after LD-EBRT ''night pain'' and ''inclusion of the complete femoral neck circumference into the PTV'' were predictive for remission. LD-EBRT represents a useful treatment option for patients suffering from GTPS. Three months after therapy two-thirds of the patients reported a partial or complete symptom remission. Especially patients who suffered from nocturnal pain seemed to benefit. Treatment appeared to be more effective when the entire circumference of the femoral neck was encompassed. (orig.) [de

Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes?

Directory of Open Access Journals (Sweden)

Sylvie Provost

2017-04-01

Full Text Available Introduction: Chronic disease management requires substantial services integration. A cardiometabolic risk management program inspired by the Chronic Care Model was implemented in Montréal for patients with diabetes or hypertension. One of this study's objectives was to assess the impact of care coordination between the interdisciplinary teams and physicians on patient participation in the program, lifestyle improvements and disease control. Methods: We obtained data on health outcomes from a register of clinical data, questionnaires completed by patients upon entry into the program and at the 12-month mark, and we drew information on the program's characteristics from the implementation analysis. We conducted multiple regression analyses, controlling for patient sociodemographic and health characteristics to measure the association between interdisciplinary team coordination with primary care physicians and various health outcomes. Results: A total of 1689 patients took part in the study (60.1% participation rate. Approximately 40% of patients withdrew from the program during the first year. At the 12-month follow-up (n = 992, we observed a significant increase in the proportion of patients achieving the various clinical targets. The perception by the interdisciplinary team of greater care coordination with primary care physicians was associated with increased participation in the program and the achievement of better clinical results. Conclusion: Greater coordination of patient services between interdisciplinary teams and primary care physicians translates into benefits for patients.

Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes?

Science.gov (United States)

Provost, Sylvie; Pineault, Raynald; Grimard, Dominique; Pérez, José; Fournier, Michel; Lévesque, Yves; Desforges, Johanne; Tousignant, Pierre; Borgès Da Silva, Roxane

2017-04-01

Chronic disease management requires substantial services integration. A cardiometabolic risk management program inspired by the Chronic Care Model was implemented in Montréal for patients with diabetes or hypertension. One of this study's objectives was to assess the impact of care coordination between the interdisciplinary teams and physicians on patient participation in the program, lifestyle improvements and disease control. We obtained data on health outcomes from a register of clinical data, questionnaires completed by patients upon entry into the program and at the 12-month mark, and we drew information on the program's characteristics from the implementation analysis. We conducted multiple regression analyses, controlling for patient sociodemographic and health characteristics, to measure the association between interdisciplinary team coordination with primary care physicians and various health outcomes. A total of 1689 patients took part in the study (60.1% participation rate). Approximately 40% of patients withdrew from the program during the first year. At the 12-month follow-up (n = 992), we observed a significant increase in the proportion of patients achieving the various clinical targets. The perception by the interdisciplinary team of greater care coordination with primary care physicians was associated with increased participation in the program and the achievement of better clinical results. Greater coordination of patient services between interdisciplinary teams and primary care physicians translates into benefits for patients.

Empowering Students through Outcome-Based Education (OBE)

Science.gov (United States)

Kaliannan, Maniam; Chandran, Suseela Devi

2012-01-01

There has been greater attention in recent times on the outcomes of the education system so that the return on investments in education could be evaluated. It is measured based on tangible performance indicators and intangible students' outcome known as outcome-based education (OBE). Universiti Teknologi MARA Malaysia has implemented an OBE system…

Predictors of Positive Outcomes in Offspring of Depressed Parents and Non-depressed Parents Across 20 Years

Science.gov (United States)

Verdeli, Helen; Wickramaratne, Priya; Warner, Virginia; Mancini, Anthony; Weissman, Myrna

2014-01-01

Understanding differences in factors leading to positive outcomes in high-risk and low-risk offspring has important implications for preventive interventions. We identified variables predicting positive outcomes in a cohort of 235 offspring from 76 families in which one, both, or neither parent had major depressive disorder. Positive outcomes were termed resilient in offspring of depressed parents, and competent in offspring of non-depressed parents, and defined by two separate criteria: absence of psychiatric diagnosis and consistently high functioning at 2, 10, and 20 years follow-up. In offspring of depressed parents, easier temperament and higher self-esteem were associated with greater odds of resilient outcome defined by absence of diagnosis. Lower maternal overprotection, greater offspring self-esteem, and higher IQ were associated with greater odds of resilient outcome defined by consistently high functioning. Multivariate analysis indicated that resilient outcome defined by absence of diagnosis was best predicted by offspring self-esteem; resilient outcome defined by functioning was best predicted by maternal overprotection and self-esteem. Among offspring of non-depressed parents, greater family cohesion, easier temperament and higher self-esteem were associated with greater odds of offspring competent outcome defined by absence of diagnosis. Higher maternal affection and greater offspring self-esteem were associated with greater odds of competent outcome, defined by consistently high functioning. Multivariate analysis for each criterion indicated that competent outcome was best predicted by offspring self-esteem. As the most robust predictor of positive outcomes in offspring of depressed and non-depressed parents, self-esteem is an important target for youth preventive interventions. PMID:25374449

Greater happiness for a greater number: Is that possible in Austria?

NARCIS (Netherlands)

R. Veenhoven (Ruut)

2011-01-01

textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the happiness of the great number could not be measured

Greater happiness for a greater number: Is that possible in Germany?

NARCIS (Netherlands)

R. Veenhoven (Ruut)

2009-01-01

textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the Happiness of the great number could not be measured

Greater Occipital Nerve Treatment in the Management of Spontaneous Intracranial Hypotension Headache: A Case Report.

Science.gov (United States)

Niraj, G; Critchley, Peter; Kodivalasa, Mahesh; Dorgham, Mohammed

2017-06-01

Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in the management of PDPH. We present the first report of greater occipital nerve treatment in SIHH. A 40-year-old male presented with a 2-year history of daily postural headaches having a significant impact on quality of life. Magnetic resonance imaging revealed bilateral convexity subdural collections. Post gadolinium scan revealed pachymeningeal enhancement with reduced pontomesencephalic angle below 50 degrees. The patient was offered an epidural blood patch and greater occipital nerve block with corticosteroids. The patient chose occipital nerve block. The patient reported significant short-term benefit lasting 4 months. Thereafter, the patient underwent pulsed radiofrequency treatment to bilateral greater occipital nerves. He reported significant benefit lasting 10 months. Greater occipital nerve treatment may have a role in management of SIHH. © 2017 American Headache Society.

Beta oscillations reflect supramodal information during perceptual judgment.

Science.gov (United States)

Haegens, Saskia; Vergara, José; Rossi-Pool, Román; Lemus, Luis; Romo, Ranulfo

2017-12-26

Previous work on perceptual decision making in the sensorimotor system has shown population dynamics in the beta band, corresponding to the encoding of stimulus properties and the final decision outcome. Here, we asked how oscillatory dynamics in the medial premotor cortex (MPC) contribute to supramodal perceptual decision making. We recorded local field potentials (LFPs) and spikes in two monkeys trained to perform a tactile-acoustic frequency discrimination task, including both unimodal and crossmodal conditions. We studied the role of oscillatory activity as a function of stimulus properties (frequency and sensory modality), as well as decision outcome. We found that beta-band power correlated with relevant stimulus properties: there was a significant modulation by stimulus frequency during the working-memory (WM) retention interval, as well as modulation by stimulus modality-the latter was observed only in the case of a purely unimodal task, where modality information was relevant to prepare for the upcoming second stimulus. Furthermore, we found a significant modulation of beta power during the comparison and decision period, which was predictive of decision outcome. Finally, beta-band spike-field coherence (SFC) matched these LFP observations. In conclusion, we demonstrate that beta power in MPC is reflective of stimulus features in a supramodal, context-dependent manner, and additionally reflects the decision outcome. We propose that these beta modulations are a signature of the recruitment of functional neuronal ensembles, which encode task-relevant information.

Sexual predators, energy development, and conservation in greater Yellowstone.

Science.gov (United States)

Berger, Joel; Beckmann, Jon P

2010-06-01

In the United States, as elsewhere, a growing debate pits national energy policy and homeland security against biological conservation. In rural communities the extraction of fossil fuels is often encouraged because of the employment opportunities it offers, although the concomitant itinerant workforce is often associated with increased wildlife poaching. We explored possible positive and negative factors associated with energy extraction in the Greater Yellowstone Ecosystem (GYE), an area known for its national parks, intact biological diversity, and some of the New World's longest terrestrial migrations. Specifically, we asked whether counties with different economies-recreation (ski), agrarian (ranching or farming), and energy extractive (petroleum)-differed in healthcare (gauged by the abundance of hospital beds) and in the frequency of sexual predators. The absolute and relative frequency of registered sex offenders grew approximately two to three times faster in areas reliant on energy extraction. Healthcare among counties did not differ. The strong conflation of community dishevel, as reflected by in-migrant sexual predators, and ecological decay in Greater Yellowstone is consistent with patterns seen in similar systems from Ecuador to northern Canada, where social and environmental disarray exist around energy boomtowns. In our case, that groups (albeit with different aims) mobilized campaigns to help maintain the quality of rural livelihoods by protecting open space is a positive sign that conservation can matter, especially in the face of rampant and poorly executed energy extraction projects. Our findings further suggest that the public and industry need stronger regulatory action to instill greater vigilance when and where social factors and land conversion impact biological systems.

Pediatric polytrauma : Short-term and long-term outcomes

NARCIS (Netherlands)

vanderSluis, CK; Kingma, J; Eisma, WH; tenDuis, HJ

Objective: To assess the short-term and long-term outcomes of pediatric polytrauma patients and to analyze the extent to which short-term outcomes can predict long-term outcomes. Materials and Methods: Ail pediatric polytrauma patients (Injury Severity Score of greater than or equal to 16, less than

Explaining Differences in Learning Outcomes in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

2014-01-01

In this paper we use a learner perspective on learning outcomes which reflects that some students taking accounting classes are also provided with on-the-job training in accounting firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators...

Spontaneous Self-Distancing and Adaptive Self-Reflection Across Adolescence.

Science.gov (United States)

White, Rachel E; Kross, Ethan; Duckworth, Angela L

2015-07-01

Experiments performed primarily with adults show that self-distancing facilitates adaptive self-reflection. However, no research has investigated whether adolescents spontaneously engage in this process or whether doing so is linked to adaptive outcomes. In this study, 226 African American adolescents, aged 11-20, reflected on an anger-related interpersonal experience. As expected, spontaneous self-distancing during reflection predicted lower levels of emotional reactivity by leading adolescents to reconstrue (rather than recount) their experience and blame their partner less. Moreover, the inverse relation between self-distancing and emotional reactivity strengthened with age. These findings highlight the role that self-distancing plays in fostering adaptive self-reflection in adolescence, and begin to elucidate the role that development plays in enhancing the benefits of engaging in this process. © 2015 The Authors. Child Development © 2015 Society for Research in Child Development, Inc.

Professional Rugby Union players have a 60% greater risk of time loss injury after concussion: a 2-season prospective study of clinical outcomes

Science.gov (United States)

Cross, Matthew; Kemp, Simon; Smith, Andrew; Trewartha, Grant; Stokes, Keith

2016-01-01

Aim To investigate incidence of concussion, clinical outcomes and subsequent injury risk following concussion. Methods In a two-season (2012/2013, 2013/2014) prospective cohort study, incidence of diagnosed match concussions (injuries/1000 h), median time interval to subsequent injury of any type (survival time) and time spent at each stage of the graduated return to play pathway were determined in 810 professional Rugby Union players (1176 player seasons). Results Match concussion incidence was 8.9/1000 h with over 50% occurring in the tackle. Subsequent incidence of any injury for players who returned to play in the same season following a diagnosed concussion (122/1000 h, 95% CI 106 to 141) was 60% higher (IRR 1.6, 95% CI 1.4 to 1.8) than for those who did not sustain a concussion (76/1000 h, 95% CI 72 to 80). Median time to next injury following return to play was shorter following concussion (53 days, 95% CI 41 to 64) than following non-concussive injuries (114 days, 95% CI 85 to 143). 38% of players reported recurrence of symptoms or failed to match their baseline neurocognitive test during the graduated return to play protocol. Summary and conclusions Players who returned to play in the same season after a diagnosed concussion had a 60% greater risk of time-loss injury than players without concussion. A substantial proportion of players reported recurrence of symptoms or failed to match baseline neurocognitive test scores during graduated return to play. These data pave the way for trials of more conservative and comprehensive graduated return to play protocols, with a greater focus on active rehabilitation. PMID:26626266

[Comparative study of reflectance spectroscopy of women's acupoints around menstruation].

Science.gov (United States)

Jiang, Xing-Hui; Liu, Han-Ping; Guo, Zhou-Yi; Meng, Yao-Yong; Zeng, Chang-Chun; Liu, Song-Hao

2010-12-01

Acupoint was reaction of viscera and its optical parameter was an important characteristic of tissue. In the present work, in order to discuss specificity of acupuncture on the response of qi and blood in human body, we compared the diffuse reflectance of Taichong (LV3), Taibai (SP3), and Chongyang (ST42) before, during and after menstruation. All the acupoints had the same shape of the spectrum and troughs were all at 423.16, 544.06 and 577.47 nm. The values of reflectance during menstruation were greater than before and after menstruation, especially for SP3 and ST42 (P menstruation. Diffuse reflectance may be possibly used in the quantitative analysis of qi and blood.

Determinants of Self-Reflective Learning and Its Consequences in Online Master Degree Programs

Science.gov (United States)

Neumann, Yoram; Neumann, Edith; Lewis, Shelia

2017-01-01

Based on recent studies of self-reflective learning and its effects on various learning outcomes, this study examined the concept of self-reflective learning in the context of the Robust Learning Model (RLM), which is a learning model designed for improving the educational effectiveness of online degree programs. Two models were introduced to…

Outcomes of dental hygiene baccalaureate degree education in Canada.

Science.gov (United States)

Kanji, Zul; Sunell, Susanne; Boschma, Geertje; Imai, Pauline; Craig, Bonnie J

2011-03-01

There is little published literature about the outcomes of dental hygiene baccalaureate degree education, particularly in Canada. Since there are various dental hygiene entry-to-practice educational models in Canada, exploring baccalaureate dental hygiene education is becoming an increasingly important subject. The purpose of this study was to explore the personal outcomes and dental hygiene practice outcomes of dental hygiene degree-completion education in Canada from the perspectives of diploma dental hygienists who have continued their education to the bachelor's degree level. This study employed a qualitative phenomenological design, using a maximum variation purposeful sampling strategy. Data generation occurred with sixteen dental hygienists across Canada through individual semistructured interviews. Interviews were audiorecorded, transcribed verbatim, and coded for data analysis, involving pattern recognition and thematic development. Themes that emerged included changes in self-perception, values, and knowledge base. Changes in self-perception were reflected in a reported increase in self-confidence and perceived credibility. Changes in values included a greater appreciation for lifelong learning. Advancements in knowledge strengthened the development of specific abilities that ultimately influenced participants' dental hygiene practice. These abilities included an increased ability to think critically, to make evidence-based decisions, and to provide more comprehensive care. Participants also commented on having more career opportunities available to them outside of the private clinical practice setting. These results reveal important insights into the impact of earning a dental hygiene baccalaureate degree on oneself and one's dental hygiene practice.

First derivative versus absolute spectral reflectance of citrus varieties

Science.gov (United States)

Blazquez, Carlos H.; Nigg, H. N.; Hedley, Lou E.; Ramos, L. E.; Sorrell, R. W.; Simpson, S. E.

1996-06-01

Spectral reflectance measurements from 400 to 800 nm were taken from immature and mature leaves of grapefruit ('McCarty' and 'Rio Red'), 'Minneola' tangelo, 'Satsuma' mandarin, 'Dancy' tangerine, 'Nagami' oval kumquat, and 'Valencia' sweet orange, at the Florida Citrus Arboretum, Division of Plant Industry, Winter Haven, Florida. Immature and mature leaves of 'Minneola' tangelo had greater percent reflectance in the 400 to 800 nm range than the other varieties and leaf ages measured. The slope of the citrus spectral curves in the 800 nm range was not as sharp as conventional spectrometers, but had a much higher reflectance value than those obtained with a DK-2 spectrometer. Statistical analyses of absolute spectral data yielded significant differences between mature and immature leaves and between varieties. First derivative data analyses did not yield significant differences between varieties.

Angular distribution of diffuse reflectance from incoherent multiple scattering in turbid media.

Science.gov (United States)

Gao, M; Huang, X; Yang, P; Kattawar, G W

2013-08-20

The angular distribution of diffuse reflection is elucidated with greater understanding by studying a homogeneous turbid medium. We modeled the medium as an infinite slab and studied the reflection dependence on the following three parameters: the incident direction, optical depth, and asymmetry factor. The diffuse reflection is produced by incoherent multiple scattering and is solved through radiative transfer theory. At large optical depths, the angular distribution of the diffuse reflection with small incident angles is similar to that of a Lambertian surface, but, with incident angles larger than 60°, the angular distributions have a prominent reflection peak around the specular reflection angle. These reflection peaks are found originating from the scattering within one transport mean free path in the top layer of the medium. The maximum reflection angles for different incident angles are analyzed and can characterize the structure of angular distributions for different asymmetry factors and optical depths. The properties of the angular distribution can be applied to more complex systems for a better understanding of diffuse reflection.

Facilitating ethical reflection among scientists using the ethical matrix

DEFF Research Database (Denmark)

Jensen, Karsten Klint; Forsberg, Ellen-Marie; Gamborg, Christian

2011-01-01

Several studies have indicated that scientists are likely to have an outlook on both facts and values that are different to that of lay people in important ways. This is one significant reason it is currently believed that in order for scientists to exercise a reliable ethical reflection about...... their research it is necessary for them to engage in dialogue with other stakeholders. This paper reports on an exercise to encourage a group of scientists to reflect on ethical issues without the presence of external stakeholders. It reports on the use of a reflection process with scientists working in the area...... of animal disease genomics (mainly drawn from the EADGENE EC Network of Excellence). This reflection process was facilitated by using an ethical engagement framework, a modified version of the Ethical Matrix. As judged by two criteria, a qualitative assessment of the outcomes and the participants' own...

Land cover mapping of Greater Mesoamerica using MODIS data

Science.gov (United States)

Giri, Chandra; Jenkins, Clinton N.

2005-01-01

A new land cover database of Greater Mesoamerica has been prepared using moderate resolution imaging spectroradiometer (MODIS, 500 m resolution) satellite data. Daily surface reflectance MODIS data and a suite of ancillary data were used in preparing the database by employing a decision tree classification approach. The new land cover data are an improvement over traditional advanced very high resolution radiometer (AVHRR) based land cover data in terms of both spatial and thematic details. The dominant land cover type in Greater Mesoamerica is forest (39%), followed by shrubland (30%) and cropland (22%). Country analysis shows forest as the dominant land cover type in Belize (62%), Cost Rica (52%), Guatemala (53%), Honduras (56%), Nicaragua (53%), and Panama (48%), cropland as the dominant land cover type in El Salvador (60.5%), and shrubland as the dominant land cover type in Mexico (37%). A three-step approach was used to assess the quality of the classified land cover data: (i) qualitative assessment provided good insight in identifying and correcting gross errors; (ii) correlation analysis of MODIS- and Landsat-derived land cover data revealed strong positive association for forest (r2 = 0.88), shrubland (r2 = 0.75), and cropland (r2 = 0.97) but weak positive association for grassland (r2 = 0.26); and (iii) an error matrix generated using unseen training data provided an overall accuracy of 77.3% with a Kappa coefficient of 0.73608. Overall, MODIS 500 m data and the methodology used were found to be quite useful for broad-scale land cover mapping of Greater Mesoamerica.

Greater physician involvement improves coding outcomes in endobronchial ultrasound-guided transbronchial needle aspiration procedures.

Science.gov (United States)

Pillai, Anilkumar; Medford, Andrew R L

2013-01-01

Correct coding is essential for accurate reimbursement for clinical activity. Published data confirm that significant aberrations in coding occur, leading to considerable financial inaccuracies especially in interventional procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Previous data reported a 15% coding error for EBUS-TBNA in a U.K. service. We hypothesised that greater physician involvement with coders would reduce EBUS-TBNA coding errors and financial disparity. The study was done as a prospective cohort study in the tertiary EBUS-TBNA service in Bristol. 165 consecutive patients between October 2009 and March 2012 underwent EBUS-TBNA for evaluation of unexplained mediastinal adenopathy on computed tomography. The chief coder was prospectively electronically informed of all procedures and cross-checked on a prospective database and by Trust Informatics. Cost and coding analysis was performed using the 2010-2011 tariffs. All 165 procedures (100%) were coded correctly as verified by Trust Informatics. This compares favourably with the 14.4% coding inaccuracy rate for EBUS-TBNA in a previous U.K. prospective cohort study [odds ratio 201.1 (1.1-357.5), p = 0.006]. Projected income loss was GBP 40,000 per year in the previous study, compared to a GBP 492,195 income here with no coding-attributable loss in revenue. Greater physician engagement with coders prevents coding errors and financial losses which can be significant especially in interventional specialties. The intervention can be as cheap, quick and simple as a prospective email to the coding team with cross-checks by Trust Informatics and against a procedural database. We suggest that all specialties should engage more with their coders using such a simple intervention to prevent revenue losses. Copyright © 2013 S. Karger AG, Basel.

The Effects of Reflective Activities on Skill Adaptation in a Work-Related Instrumental Learning Setting

Science.gov (United States)

Roessger, Kevin M.

2014-01-01

In work-related instrumental learning contexts, the role of reflective activities is unclear. Kolb's experiential learning theory and Mezirow's transformative learning theory predict skill adaptation as an outcome. This prediction was tested by manipulating reflective activities and assessing participants' response and error rates during novel…

The Reflective Learning Continuum: Reflecting on Reflection

Science.gov (United States)

Peltier, James W.; Hay, Amanda; Drago, William

2005-01-01

The importance of reflection to marketing educators is increasingly recognized. However, there is a lack of empirical research that considers reflection within the context of both the marketing and general business education literature. This article describes the use of an instrument that can be used to measure four identified levels of a…

Age, overtime, and employee health, safety and productivity outcomes: a case study.

Science.gov (United States)

Allen, Harris; Woock, Christopher; Barrington, Linda; Bunn, William

2008-08-01

To expand a study of the impact of overtime on employee health, safety, and productivity outcomes, previously reported in this journal, with tests comparing older versus younger workers on these relationships. Secondary analyses of a longitudinal panel (n = 2746) representing workers at US sites for a heavy manufacturer during 2001 to 2002. Structural equation techniques were used to assess two hypotheses in the context of multiple group models positing the prediction of a broad set of employee outcomes using a three-step causal sequence. One set of models compared overtime impact for three age groups (increases were largely confined to hourly employees working extended overtime (averaging 60+ hours per week) and occurred on only four of the nine study outcomes. With respect to moderate overtime (48.01 to 59.99 hours) and to variables reflecting the possible impact of past overtime (eg, prior disability episodes), increases in age among hourly employees did not lead to stronger associations between overtime and adverse outcomes on most tests and in fact in many cases were linked to decrements in these associations (hypothesis #2). Salaried employees recorded no greater linkages between overtime and adverse outcomes with advancing age across all tests involving hypothesized overtime effects or "possibly a function of overtime" effects. The results support the proposition that, when employees work overtime, adverse outcomes--and indirect costs--do not increase with advancing age in any kind of wholesale fashion. Where rates of adverse outcomes do increase, they are confined to certain subgroups of employees doing certain types of work and occur on certain dimensions at certain levels of longer work hours. It is argued that carefully calibrated approaches vis-à-vis older workers are needed to maximize employer capacity to address the unique challenges posed by this increasingly important portion of the workforce.

The Low-Back Outcome Scale and the Oswestry disability index: are they reflective of patient satisfaction after discectomy? A cross sectional study.

Science.gov (United States)

Azimi, Parisa; Benzel, Edward C

2017-12-01

The Low-Back Outcome Scale (LBOS) of Greenough and Fraser and the Oswestry disability index (ODI) were compared to the patient satisfaction index (PSI) in lumbar disc herniation (LDH) surgery. A total of 134 patients who underwent discectomy were followed through assessment of pre- and post-surgical satisfaction by the PSI, the LBOS, and the ODI. The LBOS were rated as satisfied if the outcomes were excellent or good and as dissatisfied if fair and poor. Considering the ODI, clinically satisfied was defined as a 13-point improvement from the baseline ODI scores. Phi (Φ) correlation analysis was used to study the correlation among the PSI, the LBOS and the ODI scores as proxy for patients' satisfaction. Mean age of patients was 48.9 years. Significant improvement from the pre- to post-operative ODI scores was observed. Post-surgical satisfaction based on the PSI, the ODI, and the LBOS were 70.9%, 76.8%, and 81.3%, respectively. Regarding patient satisfaction, there were weak associations between LBOS vs. PSI and ODI vs. PSI (Φ=-0.054, P=0.533) and (Φ=-0.129, P=0.136), respectively. Our study showed that the ODI and the LBOS were not reflective of patients' satisfaction after discectomy.

Oral Rehabilitation Outcomes Network-ORONet

NARCIS (Netherlands)

Bassi, Francesco; Carr, Alan B.; Chang, Ting-Ling; Estafanous, Emad; Garrett, Neal R.; Happonen, Risto-Pekka; Koka, Sreenivas; Laine, Juhani; Osswald, Martin; Reintsema, Harry; Rieger, Jana; Roumanas, Eleni; Salinas, Thomas J.; Stanford, Clark M.; Wolfaardt, Johan

2013-01-01

The published literature describing clinical evidence used in treatment decision-making for the management of tooth loss continues to be characterized by a lack of consistent outcome measures reflecting not only clinical performance but also a range of patient concerns. Recognizing this problem, an

Mobile and Online Learning Journal: Effects on Apprentices' Reflection in Vocational Education and Training

Science.gov (United States)

Mauroux, Laetitia; Könings, Karen D.; Zufferey, Jessica Dehler; Gurtner, Jean-Luc

2014-01-01

While learning journals (LJs) have been shown to support self-regulated learning strategies, reflection and learning outcomes in academic contexts, few studies have investigated their relevance in vocational education. A mobile and online learning journal (MOLJ) was developed to support reflection on workplace experiences. However, acceptance of…

Mapping Plant Functional Groups in Subalpine Grassland of the Greater Caucasus

Directory of Open Access Journals (Sweden)

Anja Magiera

2018-02-01

Full Text Available Plant functional groups—in our case grass, herbs, and legumes—and their spatial distribution can provide information on key ecosystem functions such as species richness, nitrogen fixation, and erosion control. Knowledge about the spatial distribution of plant functional groups provides valuable information for grassland management. This study described and mapped the distribution of grass, herb, and legume coverage of the subalpine grassland in the high-mountain Kazbegi region, Greater Caucasus, Georgia. To test the applicability of new sensors, we compared the predictive power of simulated hyperspectral canopy reflectance, simulated multispectral reflectance, simulated vegetation indices, and topographic variables for modeling plant functional groups. The tested grassland showed characteristic differences in species richness; in grass, herb, and legume coverage; and in connected structural properties such as yield. Grass (Hordeum brevisubulatum was dominant in biomass-rich hay meadows. Herb-rich grassland featured the highest species richness and evenness, whereas legume-rich grassland was accompanied by a high coverage of open soil and showed dominance of a single species, Astragalus captiosus. The best model fits were achieved with a combination of reflectance, vegetation indices, and topographic variables as predictors. Random forest models for grass, herb, and legume coverage explained 36%, 25%, and 37% of the respective variance, and their root mean square errors varied between 12–15%. Hyperspectral and multispectral reflectance as predictors resulted in similar models. Because multispectral data are more easily available and often have a higher spatial resolution, we suggest using multispectral parameters enhanced by vegetation indices and topographic parameters for modeling grass, herb, and legume coverage. However, overall model fits were merely moderate, and further testing, including stronger gradients and the addition of

Content validity and nursing sensitivity of community-level outcomes from the Nursing Outcomes Classification (NOC).

Science.gov (United States)

Head, Barbara J; Aquilino, Mary Lober; Johnson, Marion; Reed, David; Maas, Meridean; Moorhead, Sue

2004-01-01

To evaluate the content validity and nursing sensitivity of six community-level outcomes from the Nursing Outcomes Classification (NOC; Johnson, Maas, & Moorhead, 2000). A survey research design was used. Questionnaires were mailed to 300 public health nursing experts; 102 nurses responded. Experts evaluated between 11 and 30 indicators for each of the six outcomes for: (a) importance of the indicators for measuring the outcome, and (b) influence of nursing on the indicators. Content validity and nursing sensitivity of the outcomes were estimated with a modified Fehring technique. All outcomes were deemed important; only Community Competence had an outcome content validity score < .80. The outcome sensitivity score for Community Health: Immunity was .80; other outcome scores ranged from .62-.70. Indicator ratios for all 102 indicators met the study criterion for importance, with 87% designated as critical and 13% as supplemental. Sensitivity ratios reflected judgments that 45% of the indicators were sensitive to nursing intervention. The study provided evidence of outcome content validity and nursing sensitivity of the study outcomes; further validation research is recommended, followed by testing of the study outcomes in clinical practice. Community-level nursing-sensitive outcomes will potentially enable study of the efficacy and effectiveness of public health interventions focused on improving health of populations and communities.

Reflective Practice as a Fuel for Organizational Learning

Directory of Open Access Journals (Sweden)

Kati Tikkamäki

2013-07-01

Full Text Available Learning theories and their interpretations in management research recognize the role of reflection as a central element in the learning process. There also exists a broad consensus that organizational learning (OL happens at three intertwined levels of the individual, the group and the organization. This tri-level analysis has been most influentially presented by Crossan, Lane and White (1999, as a premise for their 4I framework of OL. Though the 4I framework builds strongly on existing literature on OL, it does not address the role of reflection as a factor operating between the inputs and outcomes in 4I sub-processes. Though a large body of research exists regarding the notion of reflection and its importance in terms of OL, this has not been discussed in the specific context of the 4I framework. This article contributes to the development of the 4I model by discussing how reflective practice—on three levels and within 4I sub-processes—fuels the OL process. The argumentation is based on an extensive literature review in three dimensions of learning, illustrated with an empirical inquiry into three business organizations and their reflective practice. In addition, the aim is to increase the understanding of reflection as not only an individual or group process, but as an organized practice, enabled by the tools of management control.

Periodontal Disease and Pregnancy Outcomes

OpenAIRE

Babalola, Dolapo A.; Omole, Folashade

2010-01-01

An increasing number of studies are confirming an association between periodontal disease (PD) and adverse outcomes in pregnancy. PD places pregnant women at greater risk for preterm birth than alcohol consumption or smoking. This underscores the importance of offering dental screening to women who are pregnant or contemplating pregnancy and the need for physicians who provide obstetric care to be aware of the possible connection between poor dental health and poor pregnancy outcomes.

The Active Structure of the Greater Dead Sea Basin

Science.gov (United States)

Shamir, G.

2002-12-01

The Greater Dead Sea Basin (GDSB) is a 220km long depression situated along the southern section of the Dead Sea Transform (DST), between two structurally and gravitationally elevated points, Wadi Malih in the north and Paran fault zone in the south. In its center is the Dead Sea basin 'sensu strictu' (DSB), which has been described since the 1970s as a pull-apart basin at a left step-over along the DST. However, several observations, or their lack thereof, contradict this scheme, e.g. (i) It is not supported by recent seismological and geomorphic data; (ii) It does not explain the fault pattern and mixed sinistral and dextral offset along the DSB western boundary; (iii) It does not simply explain the presence of intense deformation outside the presumed fault step zone; (iv) It is inconsistent with the orientation of seismically active faults within the Dead Sea and Jericho Valley; (v) The length of the DSB exceeds the total offset along the Dead Sea Transform, while its subsidence is about the age of the DST. In this study, newly acquired and analyzed data (high resolution seismic reflection and earthquake relocation and fault plane solutions) has been integrated with previously published data (structural mapping, fracture orientation distribution, Bouguer anomaly maps, sinkhole distribution, geomorphic lineaments). The results show that the GDSB is dominated by two active fault systems, one trending NNE and showing normal-dextral motion, the other trending NW. These systems are identified by earthquake activity, seismic reflection observations, alignment of recent sinkholes, and distribution of Bouguer anomaly gradients. As a result, the intra-basin structure is of a series of rectangular blocks. The dextral slip component along NNE trending faults, the mixed sense of lateral offset along the western boundary of the DSB and temporal change in fracture orientation in the Jericho Valley suggest that the intra-basin blocks have rotated counterclockwise since the

Greater happiness for a greater number: Is that possible? If so how? (Arabic)

NARCIS (Netherlands)

R. Veenhoven (Ruut); E. Samuel (Emad)

2012-01-01

textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time, the happiness of the great number could not be

Periodontal Disease and Pregnancy Outcomes

Directory of Open Access Journals (Sweden)

Dolapo A. Babalola

2010-01-01

Full Text Available An increasing number of studies are confirming an association between periodontal disease (PD and adverse outcomes in pregnancy. PD places pregnant women at greater risk for preterm birth than alcohol consumption or smoking. This underscores the importance of offering dental screening to women who are pregnant or contemplating pregnancy and the need for physicians who provide obstetric care to be aware of the possible connection between poor dental health and poor pregnancy outcomes.

Brief Report: Intuitive and Reflective Reasoning in Autism Spectrum Disorder

Science.gov (United States)

Brosnan, Mark; Ashwin, Chris; Lewton, Marcus

2017-01-01

Dual Process Theory has recently been applied to Autism spectrum disorder (ASD) to suggest that reasoning by people with ASD and people with higher levels of ASD-like traits can be characterised by reduced intuitive and greater reflective processing. 26 adolescents and adults with ASD and 22 adolescent and adult controls completed an assessment of…

Challenging Narcissus, or Reflecting on Reflecting.

Science.gov (United States)

Achilles, C. M.

The concept of reflective practice and teaching people to be reflective practitioners is examined. The document begins with a look at professional knowledge according to three prominent professionals in the educational administration field: Schon, Schein, and Achilles. "Reflective" strategies that could be incorporated into courses and…

Positronium reflection and positronium beams

International Nuclear Information System (INIS)

Weber, M.; Tang, S.; Khatri, R.; Roellig, L.O.; Viescas, A.J.; Berko, S.; Canter, K.F.; Lynn, K.G.; Mills, A.P. Jr.

1989-01-01

We have observed specular reflection of positronium, Ps, and established that there is adequate intensity at higher energies to make further study worthwhile. The scattering appears to be restricted to the outermost surface with a mean free path of (0.75 ± 0.15)Angstrom for Ps in LiF(100). With a greater intensity Ps beam one should see higher order diffraction beams as the result of the periodicity of the surface. Ps diffraction thus offers the possibility of being a novel and valuable probe to study the outermost surface and to study adsorbents on it. Two methods for producing Ps beams are described. 29 refs., 11 figs

Determinants of outcome for patients undergoing lumbar discectomy: a pilot study.

LENUS (Irish Health Repository)

Hickey, Oonagh T

2010-08-01

One-third of patients who undergo lumbar discectomy continue to suffer from persistent pain postoperatively. Greater preoperative warmth thresholds and greater preoperative cerebrospinal fluid concentrations of stable serum nitric oxide metabolites are associated with a worse outcome. The principal objective of this study was to examine the relationship between patient outcome (defined using the Modified Stauffer-Coventry evaluating criteria) and preoperative pain perception threshold to an electrical stimulus.

Introducing Matrix Management within a Children's Services Setting--Personal Reflections

Science.gov (United States)

Brooks, Michael; Kakabadse, Nada K.

2014-01-01

This article reflects on the introduction of "matrix management" arrangements for an Educational Psychology Service (EPS) within a Children's Service Directorate of a Local Authority (LA). It seeks to demonstrate critical self-awareness, consider relevant literature with a view to bringing insights to processes and outcomes, and offers…

Costs and outcomes associated with IVF using recombinant FSH.

Science.gov (United States)

Ledger, W; Wiebinga, C; Anderson, P; Irwin, D; Holman, A; Lloyd, A

2009-09-01

Cost and outcome estimates based on clinical trial data may not reflect usual clinical practice, yet they are often used to inform service provision and budget decisions. To expand understanding of assisted reproduction treatment in clinical practice, an economic evaluation of IVF/intracytoplasmic sperm injection (ICSI) data from a single assisted conception unit (ACU) in England was performed. A total of 1418 IVF/ICSI cycles undertaken there between October 2001 and January 2006 in 1001 women were analysed. The overall live birth rate was 22% (95% CI: 19.7-24.2), with the 30- to 34-year age group achieving the highest rate (28%). The average recombinant FSH (rFSH) dose/cycle prescribed was 1855 IU. Average cost of rFSH/cycle was 646 pound(SD: 219 pound), and average total cost/cycle was 2932 pound (SD: 422 pound). Economic data based on clinical trials informing current UK guidance assumes higher doses of rFSH dose/cycle (1750-2625 IU), higher average cost of drugs/cycle (1179 pound), and higher average total cost/cycle (3266 pound). While the outcomes in this study matched UK averages, total cost/cycle was lower than those cited in UK guidelines. Utilizing the protocols and (lower) rFSH dosages reported in this study may enable other ACU to provide a greater number of IVF/ICSI cycles to patients within given budgets.

Cognitive insight in psychosis: the relationship between self-certainty and self-reflection dimensions and neuropsychological measures.

Science.gov (United States)

Cooke, Michael A; Peters, Emmanuelle R; Fannon, Dominic; Aasen, Ingrid; Kuipers, Elizabeth; Kumari, Veena

2010-07-30

Cognitive insight in schizophrenia encompasses the evaluation and reinterpretation of distorted beliefs and appraisals. We investigated the neuropsychological basis of cognitive insight in psychosis. It was predicted that, like clinical insight, cognitive insight would be associated with a wide range of neuropsychological functions, but would be most strongly associated with measures of executive function. Sixty-five outpatients with schizophrenia or schizoaffective disorder were assessed on tests of intelligence quotient (IQ), executive function, verbal fluency, attention and memory, and completed the Beck Cognitive Insight Scale, which includes two subscales, self-certainty and self-reflection. Higher self-certainty scores reflect greater certainty about being right and more resistant to correction (poor insight), while higher self-reflection scores indicate the expression of introspection and the willingness to acknowledge fallibility (good insight). The self-certainty dimension of poor cognitive insight was significantly associated with lower scores on the Behavioural Assessment of Dysexecutive Syndrome; this relationship was not mediated by IQ. There were no relationships between self-reflection and any neuropsychological measures. We conclude that greater self-certainty (poor cognitive insight) is modestly associated with poorer executive function in psychotic individuals; self-reflection has no association with executive function. The self-certainty and self-reflection dimensions of cognitive insight have differential correlates, and probably different mechanisms, in psychosis. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Re-construction of action awareness depends on an internal model of action-outcome timing.

Science.gov (United States)

Stenner, Max-Philipp; Bauer, Markus; Machts, Judith; Heinze, Hans-Jochen; Haggard, Patrick; Dolan, Raymond J

2014-04-01

The subjective time of an instrumental action is shifted towards its outcome. This temporal binding effect is partially retrospective, i.e., occurs upon outcome perception. Retrospective binding is thought to reflect post-hoc inference on agency based on sensory evidence of the action - outcome association. However, many previous binding paradigms cannot exclude the possibility that retrospective binding results from bottom-up interference of sensory outcome processing with action awareness and is functionally unrelated to the processing of the action - outcome association. Here, we keep bottom-up interference constant and use a contextual manipulation instead. We demonstrate a shift of subjective action time by its outcome in a context of variable outcome timing. Crucially, this shift is absent when there is no such variability. Thus, retrospective action binding reflects a context-dependent, model-based phenomenon. Such top-down re-construction of action awareness seems to bias agency attribution when outcome predictability is low. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Spectral Reflectance of Duckweed (Lemna Gibba L.) Fronds Exposed to Ethylene Glycol

Science.gov (United States)

Dong, Weijin; Carter, Gregory A.; Barber, John T.

2001-01-01

When duckweed (Lemna Gibba L.) fronds are exposed to ethylene glycol (EG) anatomy is altered, allowing an increase in water uptake that causes a darkening of frond appearance. Spectroradiometry was used to quantify changes in frond reflectance that occurred throughout the 400-850 nm spectrum under various EG concentrations and exposure times. The threshold concentration of EG at which a reflectance change could be detected was between 35 and 40 mM, approximately the same as by visual observation. EG-induced changes in frond reflectance were maximum at concentrations of 50 mM or greater. Reflectance changes were detectable within 24h of exposure to 100 mM EG,2-3 days prior to changes in frond appearance. The spectroradiometry of duckweed may serve as a rapid and sensitive technique for detection of ecosystem exposure to EG and perhaps other stress agents.

Role of Surgeons in Determining Outcome of Histopathology ...

African Journals Online (AJOL)

fixative used, types of specimen containers and appropriate labeling of containers. ... specimen and with wide mouth and tight fitting lid) and adequacy of container .... surgeons in this respect is a reflection of greater availability of prepared ...

Measuring Learning Outcomes in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accountin...

Investigating the Impact of Formal Reflective Activities on Skill Adaptation in a Work-Related Instrumental Learning Setting

Science.gov (United States)

Roessger, Kevin M.

2013-01-01

In work-related, instrumental learning contexts the role of reflective activities is unclear. Kolb's (1985) experiential learning theory and Mezirow's transformative learning theory (2000) predict skill-adaptation as a possible outcome. This prediction was experimentally explored by manipulating reflective activities and assessing participants'…

Reflection in the training of nurses in clinical practice settings

DEFF Research Database (Denmark)

Schumann Scheel, Linda; Peters, Micah D J; Meinertz Møbjerg, Anna Christine

2017-01-01

REVIEW QUESTION/OBJECTIVE: This scoping review will seek to find answers for the following questions which will focus on the use of reflection in the education of nurses in clinical settings:The review will also extract and map data regarding: i) what outcomes have been found in relation to the use...... (e.g. first or second year undergraduate nursing students etc.); and v) barriers/challenges to the use of reflection approaches/tools. Additional details may also be extracted and mapped during the process of the scoping review and this will be explained in the final scoping review report....

Considering the Role of Tutoring in Student Engagement: Reflections from a South African University

Directory of Open Access Journals (Sweden)

Faroa Brendon Duran

2017-12-01

Full Text Available Student engagement has been defined as the extent to which students are engaged in activities that higher education research has shown to be linked with high-quality learning outcomes. The ubiquitous influence of the term ‘student engagement’ has been felt throughout the higher education landscape.  This is especially true for South African higher education where student success has been poor. South African universities have been tasked to improve the student learning experience as a component of improving success. Some of the innovative teaching and learning practices often highlighted by research which are thought to improve student engagement include: having students adopt teaching roles such as peer assessment, tutoring and mentoring. These practices are thought to promote student engagement, leading to greater student academic success. Tutoring can therefore be seen as one of the key strategies to facilitate student engagement in order to achieve academic success. The following paper considers the role of tutoring in student engagement while reflecting on strategies used at a South African university to address the challenges associated with student success.

The effect of building facade reflectivity on urban dwellers in tropics.

Science.gov (United States)

Ishak, N. M.; Hien, W. N.; Jenatabadi, H. S.; Ignatius, M.; Yaman, R.

2018-02-01

With the rapid growth and use of modern architecture practices for high-rise buildings, highly reflective materials have been adopted extensively for aesthetical reasons. However, outdoor glare from highly reflective facades might cause thermal and visual problems towards the occupants of neighbouring buildings and outdoor dwellers, particularly pedestrians. In tropical countries, this negative impact can be greater due to the higher solar radiation received throughout the year. At the present, there are few building guidelines limiting outdoor glare, or daylight reflectance from a building facade. This study aims to introduce a framework for outdoor glare studies that focus on perceived glare from highly reflective facades by pedestrians in Singapore. The introduced framework includes age, glare time, glare duration, avoidance and sensitiveness. For this study, the survey is carried out with the application of Structural Equation Modelling (SEM). This paper is helpful for planners, designers, and engineers to estimate the sensitivity of pedestrians’ discomfort glare and towards the creation of sustainable architecture in Singapore.

Facilitating ethical reflection among scientists using the ethical matrix.

Science.gov (United States)

Jensen, Karsten Klint; Forsberg, Ellen-Marie; Gamborg, Christian; Millar, Kate; Sandøe, Peter

2011-09-01

Several studies have indicated that scientists are likely to have an outlook on both facts and values that are different to that of lay people in important ways. This is one significant reason it is currently believed that in order for scientists to exercise a reliable ethical reflection about their research it is necessary for them to engage in dialogue with other stakeholders. This paper reports on an exercise to encourage a group of scientists to reflect on ethical issues without the presence of external stakeholders. It reports on the use of a reflection process with scientists working in the area of animal disease genomics (mainly drawn from the EADGENE EC Network of Excellence). This reflection process was facilitated by using an ethical engagement framework, a modified version of the Ethical Matrix. As judged by two criteria, a qualitative assessment of the outcomes and the participants' own assessment of the process, this independent reflective exercise was deemed to be successful. The discussions demonstrated a high level of complexity and depth, with participants demonstrating a clear perception of uncertainties and the context in which their research operates. Reflection on stakeholder views and values appeared to be embedded within the discussions. The finding from this exercise seems to indicate that even without the involvement of the wider stakeholder community, valuable reflection and worthwhile discourse can be generated from ethical reflection processes involving only scienitific project partners. Hence, the previous assumption that direct stakeholder engagement is necessary for ethical reflection does not appear to hold true in all cases; however, other reasons for involving a broad group of stakeholders relating to governance and social accountability of science remain.

Wavelength dependence of the bidirectional reflectance distribution function (BRDF) of beach sands.

Science.gov (United States)

Doctor, Katarina Z; Bachmann, Charles M; Gray, Deric J; Montes, Marcos J; Fusina, Robert A

2015-11-01

The wavelength dependence of the dominant directional reflective properties of beach sands was demonstrated using principal component analysis and the related correlation matrix. In general, we found that the hyperspectral bidirectional reflectance distribution function (BRDF) of beach sands has weak wavelength dependence. Its BRDF varies slightly in three broad wavelength regions. The variations are more evident in surfaces of greater visual roughness than in smooth surfaces. The weak wavelength dependence of the BRDF of beach sand can be captured using three broad wavelength regions instead of hundreds of individual wavelengths.

Nonverbal Synchrony in Psychotherapy: Coordinated Body Movement Reflects Relationship Quality and Outcome

Science.gov (United States)

Ramseyer, Fabian; Tschacher, Wolfgang

2011-01-01

Objective: The authors quantified nonverbal synchrony--the coordination of patient's and therapist's movement--in a random sample of same-sex psychotherapy dyads. The authors contrasted nonverbal synchrony in these dyads with a control condition and assessed its association with session-level and overall psychotherapy outcome. Method: Using an…

Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN)

Science.gov (United States)

2012-01-01

Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN) has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services. PMID:22640939

Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN

Directory of Open Access Journals (Sweden)

Burgess Philip

2012-05-01

Full Text Available Abstract Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services.

The Things of Design Research: Diversity in Objects and Outcomes

DEFF Research Database (Denmark)

Jenkins, Tom; Andersen, Kristina; Gaver, Bill

2017-01-01

of attending to its made-material outcomes. The premise of this workshop is simple: We need additional social spaces and platforms for interacting with and reflecting upon material design outcomes at CHI. The goal of this workshop is to keep experimenting with such a space, with an emphasis on how prototyping...

Greater-than-Class C low-level radioactive waste characterization. Appendix E-4: Packaging factors for greater-than-Class C low-level radioactive waste

International Nuclear Information System (INIS)

Quinn, G.; Grant, P.; Winberg, M.; Williams, K.

1994-09-01

This report estimates packaging factors for several waste types that are potential greater-than-Class C (GTCC) low-level radioactive waste (LLW). The packaging factor is defined as the volume of a GTCC LLW disposal container divided by the as-generated or ''unpackaged'' volume of the waste loaded into the disposal container. Packaging factors reflect any processes that reduce or increase an original unpackaged volume of GTCC LLW, the volume inside a waste container not occupied by the waste, and the volume of the waste container itself. Three values are developed that represent (a) the base case or most likely value for a packaging factor, (b) a high case packaging factor that corresponds to the largest anticipated disposal volume of waste, and (c) a low case packaging factor for the smallest volume expected. GTCC LLW is placed in three categories for evaluation in this report: activated metals, sealed sources, and all other waste

Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders.

Science.gov (United States)

Espel, Hallie M; Goldstein, Stephanie P; Manasse, Stephanie M; Juarascio, Adrienne S

2016-06-01

This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted.

Appreciative Inquiry: Guided Reflection to Generate Change in Service-Learning Courses

Science.gov (United States)

Lahman, Mary

2012-01-01

Service-learning scholars contend that engaging students in systematic reflection during community service promotes one, if not all, of the following student outcomes: (1) academic learning; (2) personal growth; and (3) civic engagement. For communication instructors in particular, Applegate and Morreale (1999) proposed that service-learning both…

The Value of Reflective: Functioning within an Academic Therapeutic Nursery.

Science.gov (United States)

LaLonde, Mary M; Dreier, Mona; Aaronson, Gayle; O'Brien, John

2015-01-01

The self begins as a social self and is dependent on the other and the self-other relationship. Furthermore, shortly after birth, the intersubjective self is nurtured and sustained by the reciprocal interactions with the significant other. Recent research suggests that the significant other's reciprocity depends on his or her capacity for mentalization, and this reflective functioning capacity influences not only the child's developing sense of I, other, and we, but also his or her developing attachment pattern. Several studies have demonstrated that parental reflective functioning can be improved with intervention, and enhancing parental reflective functioning can lead to a more secure attachment pattern and better outcomes for the child and parent. Therefore, intervention with toddlers and their families requires us to consider this dynamic two-person psychology. In this paper, we describe an academic parent-child nursery program aimed at enhancing parental reflective functioning. A clinical example from the collaborative treatment of a mother and her two-year-old will demonstrate how reflective functioning can be enhanced in the parent-child dyad and lead to a more secure parent-child relationship. We will also discuss the value of reflective functioning to the interdisciplinary team and how we dealt with countertransference issues that arose during the treatment.

Reflection: an educational strategy to develop emotionally-competent nurse leaders.

Science.gov (United States)

Horton-Deutsch, Sara; Sherwood, Gwen

2008-11-01

This paper explores educational strategies for nurses that focus on reflectivity and promote the development of self-awareness, relationship and communication skills and ability to lead with presence and compassion in the midst of change. Today nurses move rapidly from carefully-controlled educational experiences to a fast-paced clinical world of increasing patient complexity amid calls for improved quality of care. Making the transition to clinical competence and leadership in practice requires a strong sense of self and emotional intelligence. Pedagogies that integrate theoretical and data-based textbook learning with experiential learning and reflection are a foundation for the development of emotionally- and intellectually-competent leaders and requires new ways of assessing learner outcomes. Reflection is a key instructional strategy for preparing transformational nurse leaders for interdisciplinary settings where they lead patient care management. The remarkable global spread of reflection in nursing education, practice and research follows an emphasis on developing self-awareness as a leadership strategy for improving individual and organizational performance. Empirical, experiential and anecdotal evidence suggests that reflection has the potential to prepare emotionally-capable nurse leaders. As educators create more reflective and nurturing learning environments, they will promote the development of emotionally-competent nurse leaders who will, in turn, inspire individual and organizational growth and positive change in society.

Transparency of outcome reporting and trial registration of randomized controlled trials in top psychosomatic and behavioral health journals: A systematic review.

Science.gov (United States)

Milette, Katherine; Roseman, Michelle; Thombs, Brett D

2011-03-01

The most reliable evidence for evaluating healthcare interventions comes from well-designed and conducted randomized controlled trials (RCTs). The extent to which published RCTs reflect the efficacy of interventions, however, depends on the completeness and accuracy of published results. The Consolidated Standards of Reporting Trials statement, initially developed in 1996, provides guidelines intended to improve the transparency of published RCT reports. A policy of the International Committee of Medical Journal Editors, initiated in 2005, requires clinical trials published in member journals to be registered in publicly accessible registries prior to patient enrollment. The objective of this study was to assess the clarity of outcome reporting, proportion of registered trials, and adequacy of outcome registration in RCTs published in top behavioral health journals. Eligible studies were primary or secondary reports of RCTs published in Annals of Behavioral Medicine, Health Psychology, Journal of Psychosomatic Research, and Psychosomatic Medicine from January 2008 to September 2009. Data were extracted for each study on adequacy of outcome reporting and registration. Of 63 articles reviewed, only 25 (39.7%) had adequately declared primary or secondary outcomes, whereas 38 (60.3%) had multiple primary outcomes or did not define outcomes. Only 13 studies (20.6%) were registered. Only 1 study registered sufficiently precise outcome information to compare with published outcomes, and registered and published outcomes were discrepant in that study. Greater attention to outcome reporting and trial registration by researchers, peer reviewers, and journal editors will increase the likelihood that effective behavioral health interventions are readily identified and made available to patients. Copyright © 2011 Elsevier Inc. All rights reserved.

The influence of a change in medicare reimbursement on the effectiveness of stage III or greater decubitus ulcer home health nursing care.

Science.gov (United States)

Eaton, Melody K

2005-02-01

This study was designed to describe and evaluate the influence of a change in a Medicare reimbursement on the effectiveness of home health nursing care for stage III or greater decubitus ulcer patients. This health policy originated from the Balanced Budget Act (BBA) of 1997 and took its full effect with initiation of the Prospective Payment System (PPS) on October 1, 2000. A quantitative quasi-experimental design used OASIS data from the state of Virginia to evaluate 555 stage III or greater decubitus ulcer patients, age 65 or older. Comparisons were investigated between pre-PPS, 2000, and post-PPS, 2001, outcomes related to reported ulcer healing, lengths of stay, and discharge disposition. Results demonstrated significant differences for the outcomes studied. In addition, sanitation, ulcer healing, and discharge disposition were linked as predictors for length of stay. Results demonstrated that PPS has affected nursing care effectiveness for stage III or greater decubitus ulcer home health patients.

Seismic reflection imaging, accounting for primary and multiple reflections

Science.gov (United States)

Wapenaar, Kees; van der Neut, Joost; Thorbecke, Jan; Broggini, Filippo; Slob, Evert; Snieder, Roel

2015-04-01

Imaging of seismic reflection data is usually based on the assumption that the seismic response consists of primary reflections only. Multiple reflections, i.e. waves that have reflected more than once, are treated as primaries and are imaged at wrong positions. There are two classes of multiple reflections, which we will call surface-related multiples and internal multiples. Surface-related multiples are those multiples that contain at least one reflection at the earth's surface, whereas internal multiples consist of waves that have reflected only at subsurface interfaces. Surface-related multiples are the strongest, but also relatively easy to deal with because the reflecting boundary (the earth's surface) is known. Internal multiples constitute a much more difficult problem for seismic imaging, because the positions and properties of the reflecting interfaces are not known. We are developing reflection imaging methodology which deals with internal multiples. Starting with the Marchenko equation for 1D inverse scattering problems, we derived 3D Marchenko-type equations, which relate reflection data at the surface to Green's functions between virtual sources anywhere in the subsurface and receivers at the surface. Based on these equations, we derived an iterative scheme by which these Green's functions can be retrieved from the reflection data at the surface. This iterative scheme requires an estimate of the direct wave of the Green's functions in a background medium. Note that this is precisely the same information that is also required by standard reflection imaging schemes. However, unlike in standard imaging, our iterative Marchenko scheme retrieves the multiple reflections of the Green's functions from the reflection data at the surface. For this, no knowledge of the positions and properties of the reflecting interfaces is required. Once the full Green's functions are retrieved, reflection imaging can be carried out by which the primaries and multiples are

Cultural differences in emotion regulation during self-reflection on negative personal experiences.

Science.gov (United States)

Tsai, William; Lau, Anna S

2013-01-01

Reflecting on negative personal experiences has implications for mood that may vary as a function of specific domains (e.g., achievement vs. interpersonal) and cultural orientation (e.g., interdependence vs. independence). This study investigated cultural differences in the social-cognitive and affective processes undertaken as Easterners and Westerners reflected on negative interpersonal and performance experiences. One hundred Asian Americans and 92 European-American college students were randomly assigned to one of three conditions: interpersonal rejection, achievement failure, or a control condition. Results revealed that Asian Americans experienced greater distress than European Americans after self-reflecting over a failed interpersonal experience, suggesting cultural sensitivity in the relational domain. Consistent with theoretical predictions, analysis of the social cognitive and affective processes that participants engaged in during self-reflection provided some evidence that self-enhancement may buffer distress for European Americans, while emotion suppression may be adaptive for Asian Americans.

[Outcome-quality of treatment for headache on primary care conditions].

Science.gov (United States)

Lang, E; Eisele, R; Jankowsky, H; Kastner, S; Bickel, A; Martus, P; Neundörfer, B

2000-12-01

Little is known about the outcome-quality of treatment for headache on primary care conditions in Germany. All physicians (2100) of middle franconia, a bavarian greater district with 1,6 Mio. inhabitants, involved in outpatient management were asked to include consecutively patients in the study which suffer from migraine (at least 2 attacks/month) and/or tension type headache (at least 8 days/month) of at least 4 weeks duration. Before and after a 6 months interval patients documented the following outcome data in a questionnaire: pain intensity during the last attack (numeric rating scale), pain dependent disability (Brief Pain Inventory, German version), health related quality of life (SF-36, German version) and depressivity (Allgemeine Depressionsskala). The pain chronification state (Mainz Pain Staging System) has been assessed by the physician. Therapy was not standardized and included the natural spectrum of medicamental and non-medicamental therapy of headache. Agreement of therapy with recommendations of the "Arzneimittelkommission der Deutschen Aerzteschaft" has been assessed. 24 physicians participated in the study. Pre-post-data of 80 patients (46+/-14 y) could be analysed. Initially 67% were classified in pain chronification state I, 27% in state II and 6% in state III. Medicamental therapy agreed with recommendations in approximately 50% of patients, non-medicamental therapy has been used rarely. The pain intensity, pain dependent disability, depression and quality of life improved significantly. 45% and 55% of patients improved in at least 2 of 6 outcome-parameters by 30% of baseline value or by half standard deviation of the corresponding pre-post-differences, respectively. The latter outcome-measure reflects a medium effect size. On primary care conditions about 50% of patients suffering from migraine and/or tension type headache (predominantly low chronification stae) perceive a therapy effect that corresponds to a medium effect size.

Effects of Rocket Exhaust on Lunar Soil Reflectance Properties

Science.gov (United States)

Clegg, R. N.; Jolliff, B. L.; Robinson, M. S.; Hapke, B. W.; Plescia, J. B.

2012-12-01

areas; this magnitude is the same, within uncertainty, for all sites, indicating a common process or combination of processes causing differences in reflectance properties of the regolith. Phase-ratio images and photometric data collected over a range of illumination geometries show that a greater separation in reflectance occurs between the HR-BZs and undisturbed areas with increasing phase angle and indicate that the HR-BZs are less backscattering than undisturbed areas. As working hypotheses, we consider the following possibilities to explain BZ reflectance phenomena: change in macroscopic roughness, microscopic modification of surface structure, redistribution of fines (excavation from LR-BZ and deposition in HR-BZ), change in compaction, contamination from fuel, and modification of maturity. The LR-BZ is affected by macroscopic disruption of the surface and increased shadowing. We infer that HR-BZ reflectance has been affected by scouring from particles entrained by exhaust gases with low-angle trajectories. Entrained particles with trajectories greater than a few degrees relative to horizontal travel well beyond the BZ boundary and do not contribute to BZ reflectance variations. Regolith particle interactions with surface soil within HR-BZs may destroy fine-scale surface structure (e.g., "fairy-castle") and decrease macroscopic roughness, contributing to a decrease in backscattering character within the HR-BZ.

Method of combined radionuclide assessment of the greater and uteroplacental circulation in plural pregnency

International Nuclear Information System (INIS)

Illarionova, N.M.; Fuks, M.A.; Ehventov, A.Z.

1987-01-01

The paper is concerned with the results of the clinical testing of a combined radionuclide method of assessment of the greater and uteroplacentral circulation in 15 women with plural pregnancy. The method permits the detection of hemodynamic changes without increasing radiation exposure to the mother's body and fetuses, the determination of a type of plural pregnancy (monochorionic or dichorial twins), and the prediction of pregnancy outcome that is very important for the choice of appropriate and timely therapy

Metacognitive reflection and insight therapy (MERIT) for patients with schizophrenia.

Science.gov (United States)

de Jong, S; van Donkersgoed, R J M; Timmerman, M E; Aan Het Rot, M; Wunderink, L; Arends, J; van Der Gaag, M; Aleman, A; Lysaker, P H; Pijnenborg, G H M

2018-04-25

Impaired metacognition is associated with difficulties in the daily functioning of people with psychosis. Metacognition can be divided into four domains: Self-Reflection, Understanding the Other's Mind, Decentration, and Mastery. This study investigated whether Metacognitive Reflection and Insight Therapy (MERIT) can be used to improve metacognition. This study is a randomized controlled trial. Patients in the active condition (n = 35) received forty MERIT sessions, the control group (n = 35) received treatment as usual. Multilevel intention-to-treat and completers analyses were performed for metacognition and secondary outcomes (psychotic symptomatology, cognitive insight, Theory of Mind, empathy, depression, self-stigma, quality of life, social functioning, and work readiness). Eighteen out of 35 participants finished treatment, half the drop-out stemmed from therapist attrition (N = 5) or before the first session (N = 4). Intention-to-treat analysis demonstrated that in both groups metacognition improved between pre- and post-measurements, with no significant differences between the groups. Patients who received MERIT continued to improve, while the control group returned to baseline, leading to significant differences at follow-up. Completers analysis (18/35) showed improvements on the Metacognition Assessment Scale (MAS-A) scales Self Reflectivity and metacognitive Mastery at follow-up. No effects were found on secondary outcomes. On average, participants in the MERIT group were, based on MAS-A scores, at follow-up more likely to recognize their thoughts as changeable rather than as facts. MERIT might be useful for patients whose self-reflection is too limited to benefit from other therapies. Given how no changes were found in secondary measures, further research is needed. Limitations and suggestions for future research are discussed.

Adults with Greater Weight Satisfaction Report More Positive Health Behaviors and Have Better Health Status Regardless of BMI

Directory of Open Access Journals (Sweden)

Christine E. Blake

2013-01-01

Full Text Available Background. Prior studies suggest that weight satisfaction may preclude changes in behavior that lead to healthier weight among individuals who are overweight or obese. Objective. To gain a better understanding of complex relationships between weight satisfaction, weight-related health behaviors, and health outcomes. Design. Cross-sectional analysis of data from the Aerobics Center Longitudinal Study (ACLS. Participants. Large mixed-gender cohort of primarily white, middle-to-upper socioeconomic status (SES adults with baseline examination between 1987 and 2002 (n=19,003. Main Outcome Variables. Weight satisfaction, weight-related health behaviors, chronic health conditions, and clinical health indicators. Statistical Analyses Performed. Chi-square test, t-tests, and linear and multivariate logistic regression. Results. Compared to men, women were more likely to be dieting (32% women; 18% men and had higher weight dissatisfaction. Men and women with greater weight dissatisfaction reported more dieting, yo-yo dieting, and snacking and consuming fewer meals, being less active, and having to eat either more or less than desired to maintain weight regardless of weight status. Those who were overweight or obese and dissatisfied with their weight had the poorest health. Conclusion. Greater satisfaction with one’s weight was associated with positive health behaviors and health outcomes in both men and women and across weight status groups.

The role of coherence of mind and reflective functioning in understanding binge-eating disorder and co-morbid overweight.

Science.gov (United States)

Maxwell, Hilary; Tasca, Giorgio A; Grenon, Renee; Faye, Megan; Ritchie, Kerri; Bissada, Hany; Balfour, Louise

2017-08-01

Coherence of mind and reflective functioning may impact negative affect and interpersonal functioning over and above the effects of symptoms of depression and interpersonal problems that contribute to symptoms of binge-eating disorder (BED) and overweight/obesity. Matched samples of overweight women with BED and overweight and normal weight women without BED completed the Adult Attachment Interview, a measure of depressive symptoms, and a measure of interpersonal problems. Greater symptoms of depression distinguished women with BED from the matched comparison samples. Greater interpersonal problems differentiated women with BED from overweight women without BED. Coherence of Mind scores did not differentiate the samples. However, lower Reflective Functioning scores did distinguish both women with BED and overweight women without BED from normal weight women. Lower reflective functioning may lead to binge eating independent of depressive symptoms and interpersonal problems.

A systematic review of patient-reported outcome measures in paediatric otolaryngology.

Science.gov (United States)

Powell, J; Powell, S; Robson, A

2018-01-01

Recently, there has been increased emphasis on the development and application of patient-reported outcome measures. This drive to assess the impact of illness or interventions, from the patient's perspective, has resulted in a greater number of available questionnaires. The importance of selecting an appropriate patient-reported outcome measure is specifically emphasised in the paediatric population. The literature on patient-reported outcome measures used in paediatric otolaryngology was reviewed. A comprehensive literature search was conducted using the databases Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo, using the terms: 'health assessment questionnaire', 'structured questionnaire', 'questionnaire', 'patient reported outcome measures', 'PROM', 'quality of life' or 'survey', and 'children' or 'otolaryngology'. The search was limited to English-language articles published between 1996 and 2016. The search yielded 656 articles, of which 63 were considered relevant. This included general paediatric patient-reported outcome measures applied to otolaryngology, and paediatric otolaryngology disease-specific patient-reported outcome measures. A large collection of patient-reported outcome measures are described in the paediatric otolaryngology literature. Greater standardisation of the patient-reported outcome measures used in paediatric otolaryngology would assist in pooling of data and increase the validation of tools used.

The effects of types of reflective scaffolding and language proficiency on the acquisition of physics knowledge in a game-based learning environment

Science.gov (United States)

Huang, Tsu-Ting

With the capability of creating a situated and engaging learning environment, video games have been considered as a powerful tool to enhance students' learning outcomes and interest in learning. Yet, little empirical evidence exists to support the effectiveness of video games in learning. Particularly, little attention has been given to the design of specific game elements. Focusing on middle school students, the goal of this study was to investigate the effects of two types of representations of reflective scaffolds (verbal and visual) on students' learning outcomes, game performance, and level of engagement in a video game for physics learning. In addition, the role of students' level of English proficiency was examined to understand whether the effects of reflective scaffolds were influenced by students' language proficiency. Two studies were conducted. Study 1 playtested the game with target players and led to game modification for its use in Study 2, which focused on the effects of different types of reflective scaffolds and level of English proficiency. The results of Study 2 showed that students who received both verbal and visual reflective scaffolds completed the most levels compared to the other groups in the given time. No significant effect of type of reflective scaffolds were found on learning outcomes despite the fact that the pattern of the learning outcomes across conditions was close to prediction. Participants' engagement in gameplay was high regardless of the type of scaffolds they received, their interest in learning physics, and their prior knowledge of physics. The results of video analysis also showed that the game used in this study was able to engage students not only in gameplay but also in learning physics. Finally, English proficiency functioned as a significant factor moderating the effects of scaffolds, learning outcomes and game performance. Students with limited English proficiency benefited more from visual reflective scaffolds than

Exploring students' perceptions on the use of significant event analysis, as part of a portfolio assessment process in general practice, as a tool for learning how to use reflection in learning.

Science.gov (United States)

Grant, Andrew J; Vermunt, Jan D; Kinnersley, Paul; Houston, Helen

2007-03-30

be viewed alongside the high validity afforded by the authenticity of the learning tasks (compared with a sample of a student's learning taken by an exam question). Validity is enhanced by the rating scale which directly connects the grade given with intended learning outcomes. The moderate inter-rater reliability may be increased if a portfolio is completed over a longer period of time and contains more component pieces of work. The questionnaire used in this study only accessed limited information about the effect of reflection on students' learning. Qualitative methods of evaluation would determine the students experience in greater depth. It would be useful to evaluate the effects of reflective learning after students have had more time to get used to this unfamiliar method of learning and to overcome any problems in understanding the task.

Alternative outcomes create biased expectations regarding the received outcome: Evidence from event-related potentials.

Science.gov (United States)

Marciano, Déborah; Bentin, Shlomo; Deouell, Leon Y

2018-05-01

After choosing between uncertain options, one might get feedback on both the outcome of the chosen option and the outcome of the unchosen option (the alternative). Behavioral research has shown that in such cases people engage in outcome comparison, and that the alternative outcome influences the way one evaluates his own received outcome. Moreover, this influence differs whether one was responsible or not for the choice made. In two studies, we looked for the electrophysiological correlates of outcome comparison. Subjects chose one of two boxes shown on the screen, each box contained a gain or a loss. The alternative outcome was always revealed first, followed by the received outcome. In half of the trials the software picked one box instead of subjects. We tested whether the feedback-related negativity (FRN) and the P3 elicited by the received reflect outcome comparison. As expected, we found that the FRN and P3 were more positive when the received outcome was a gain (vs. a loss). The FRN and P3 were also sensitive to the value of the alternative outcome, but contrary to our predictions, they were more positive when the alternative outcome was a gain (vs. a loss). As the FRN and P3 are sensitive to expectations, we hypothesized that our findings might result from subjects' biased expectations: subjects might have wrongly believed that a good (bad) alternative outcome signaled a bad (good) received outcome. This hypothesis, coined as the Alternative Omen Effect, was confirmed in parallel in a series of behavioral experiments: people see an illusory negative correlation between the uncorrelated outcomes of choice options (reported in Marciano-Romm et al. (2016)). A challenge for future research will be to disentangle the effects of expectation from those of outcome comparison. Copyright © 2018 Elsevier Ltd. All rights reserved.

Client interpersonal impacts as mediators of long-term outcome in cognitive-behavioral therapy integrated with motivational interviewing for generalized anxiety disorder.

Science.gov (United States)

Constantino, Michael J; Romano, Felicia M; Coyne, Alice E; Westra, Henny A; Antony, Martin M

2017-03-24

A recent trial of generalized anxiety disorder treatment (Westra, H. A., Constantino, M. J., & Antony, M. M. (2016). Integrating Motivational Interviewing With Cognitive-Behavioral Therapy for Severe Generalized Anxiety Disorder: An Allegiance-Controlled Randomized Clinical Trial. Journal of Consulting and Clinical Psychology, 84, 768-782. doi: 10.1037/ccp0000098 ) revealed that cognitive-behavioral therapy (CBT) integrated with motivational interviewing (MI) outperformed CBT alone across a 12-month follow up. The present study examined whether this treatment effect was mediated by MI-CBT clients engaging over time in during-session interpersonal behaviors reflecting more friendly dominance, or agentic actions, and less friendly submissiveness (FS), or trustingly compliant actions both theory-specific MI mechanisms. Clients received 15 sessions of MI-CBT (n = 42) or CBT alone (n = 43). Therapists rated client interpersonal behavior following five sessions, and clients rated their worry at baseline, each session, and 6- and 12-month follow up. Mediator and outcome variables were derived from multilevel models. Mediation was tested using a bootstrapping procedure. There was a significant indirect effect for FS. As expected, CBT clients evidenced greater increases in FS than MI-CBT clients, which in turn, though unexpectedly, related to lower 12-month worry. However, long-term CBT outcomes remained inferior to MI-CBT outcomes even with CBT clients'greater increase in FS. Results suggest that CBT outcomes are more positive when clients trustingly comply; however, MI-CBT remained superior, but for as yet unexplained reasons. Clinical or methodological significance of this article: The findings highlight the clinical importance of GAD clients becoming more friendly dominant in the therapy relationship irrespective of whether they received CBT or integrative MI-CBT. Moreover, it seems clinically indicated to incorporate MI spirit and techniques into CBT when

Reflection and Non-Reflection of Particle Wavepackets

Science.gov (United States)

Cox, Timothy; Lekner, John

2008-01-01

Exact closed-form solutions of the time-dependent Schrodinger equation are obtained, describing the propagation of wavepackets in the neighbourhood of a potential. Examples given include zero reflection, total reflection and partial reflection of the wavepacket, for the sech[superscript 2]x/a, 1/x[superscript 2] and delta(x) potentials,…

What Outcomes do Dutch Healthcare Professionals Perceive as Important Before Participation in Moral Case Deliberation?

Science.gov (United States)

de Snoo-Trimp, Janine; Widdershoven, Guy; Svantesson, Mia; de Vet, Riekie; Molewijk, Bert

2017-05-01

There has been little attention paid to research on the outcomes of clinical ethics support (CES) or critical reflection on what constitutes a good CES outcome. Understanding how CES users perceive the importance of CES outcomes can contribute to a better understanding, use of and normative reflection on CES outcomes. To describe the perceptions of Dutch healthcare professionals on important outcomes of moral case deliberation (MCD), prior to MCD participation, and to compare results between respondents. This mixed-methods study used both the Euro-MCD instrument and semi-structured interviews. Healthcare professionals who were about to implement MCD were recruited from nursing homes, hospitals, psychiatry and mentally disabled care institutions. 331 healthcare professionals completed the Euro-MCD instrument, 13 healthcare professionals were interviewed. The outcomes perceived as most important were 'more open communication', 'better mutual understanding', 'concrete actions', 'see the situation from different perspectives', 'consensus on how to manage the situation' and 'find more courses of action'. Interviewees also perceived improving quality of care, professionalism and the organization as important. Women, nurses, managers and professionals in mentally disabled care rated outcomes more highly than other respondents. Dutch healthcare professionals perceived the MCD outcomes related to collaboration as most important. The empirical findings can contribute to shared ownership of MCD and a more specific use of MCD in different contexts. They can inform international comparative research on different CES types and contribute to normative discussions concerning CES outcomes. Future studies should reflect upon important MCD outcomes after having experienced MCD. © 2017 John Wiley & Sons Ltd.

Refining a definition of reflection for the being as well as doing the work of a physician.

Science.gov (United States)

Wald, Hedy S

2015-04-21

Reflection is core to professional competency and supports the active, constructive process of professional identity formation. Medical educators thus grapple with operationalizing and effectively integrating reflection as a foundational construct within health care professions education and practice. Core elements of reflection including role of emotions and awareness of self, other and situation, do not appear within various working definitions of reflection. This observation as well as noted recent shift in medical education toward emphasis on the "being" as well as "doing the work" of a physician led to the author's proposed refining of Sandars' reflection definition and expansion of Nguyen et al.'s reflection model. A refined reflection definition is offered for a more inclusionary approach. A caveat regarding potential for expected reflective learning outcomes (given reflection as a process) is provided and the integral role of mentor-enhanced reflection is discussed. Reflection as a continuum is highlighted and exemplified within Wald et al.'s REFLECT rubric and Nguyen et al.'s reflection model.

Effect of reflective practice education on self-reflection, insight, and reflective thinking among experienced nurses: a pilot study.

Science.gov (United States)

Asselin, Marilyn E; Fain, James A

2013-01-01

A mixed-method study was conducted to determine whether nurses' participation in a reflective practice continuing education program using a structured reflection model makes a difference in nurses' self-reflection, insight, and reflective thinking about clinical practice situations. Findings suggested that use of structured reflection using question cues, written narratives, and peer-facilitated reflection increased nurses' engagement in self-reflection and enhanced reflective thinking in practice. Including reflective practice education in novice orientation and preceptor training may be beneficial.

A fiberoptic reflection oximeter.

Science.gov (United States)

Landsman, M L; Knop, N; Kwant, G; Mook, G A; Zijlstra, W G

1978-03-20

A catheter tip oximeter is described consisting of a cardiac catheter containing optical fibers, and incandescent light source, a light detection unit and a processing unit. Half of the optical fibers guide the light to the blood at the tip of the catheter, the other half the backscattered (reflected) light to the detection unit. The detection unit contains a dichroic mirror, transmitting most of the light with lambda less than 800 nm and reflecting most of the light with lambda greater than 900 nm, thus splitting the light into two beams. These pass through interference filters with nominal wavelengths of 640 and 920 nm respectively, and are focused on silicium barrier layer photocells. The photocell signals are amplified and fed into a divider giving the ratio of measuring (R640) and compensating (R920) photocell output. The relationship between log R640/R920 and oxygen saturation is represented by a slightly curved line. The relation may be linearized by subtracting a constant voltage from the divided output before taking the logarithm. The slope of the calibration line is dependent on the total haemoglobin concentration. Nonetheless an average calibration line can be used between 70 and 100% oxygen saturation. For 78 measurements of pig blood samples in this range (haemoglobin concentration between 96 and 161 g.1(-1)), the standard deviation of the difference between the fiberoptic oximeter and a Radiometer OSM1 oxygen saturation meter was 1.9% saturation, for 152 samples over the entire saturation range the standard deviation of the difference was 3.1% saturation. The influence of the flow velocity of blood on the light reflection depends on wavelength as well as on oxygen saturation. Therefore, complete compensation for the flow effect is not possible by simple means.

Arterial stiffness and wave reflection: sex differences and relationship with left ventricular diastolic function.

Science.gov (United States)

Russo, Cesare; Jin, Zhezhen; Palmieri, Vittorio; Homma, Shunichi; Rundek, Tatjana; Elkind, Mitchell S V; Sacco, Ralph L; Di Tullio, Marco R

2012-08-01

Increased arterial stiffness and wave reflection have been reported in heart failure with normal ejection fraction (HFNEF) and in asymptomatic left ventricular (LV) diastolic dysfunction, a precursor of HFNEF. It is unclear whether women, who have higher frequency of HFNEF, are more vulnerable than men to the deleterious effects of arterial stiffness on LV diastolic function. We investigated, in a large community-based cohort, whether sex differences exist in the relationship among arterial stiffness, wave reflection, and LV diastolic function. Arterial stiffness and wave reflection were assessed in 983 participants from the Cardiovascular Abnormalities and Brain Lesions study using applanation tonometry. The central pulse pressure/stroke volume index, total arterial compliance, pulse pressure amplification, and augmentation index were used as parameters of arterial stiffness and wave reflection. LV diastolic function was evaluated by 2-dimensional echocardiography and tissue-Doppler imaging. Arterial stiffness and wave reflection were greater in women compared with men, independent of body size and heart rate (all Pfunction in both sexes. Further adjustment for cardiovascular risk factors attenuated these relationships; however, a higher central pulse pressure/stroke volume index predicted LV diastolic dysfunction in women (odds ratio, 1.54; 95% confidence intervals, 1.03 to 2.30) and men (odds ratio, 2.09; 95% confidence interval, 1.30 to 3.39), independent of other risk factors. In conclusion, in our community-based cohort study, higher arterial stiffness was associated with worse LV diastolic function in men and women. Women's higher arterial stiffness, independent of body size, may contribute to their greater susceptibility to develop HFNEF.

Prediction of Functional Outcome in Axonal Guillain-Barre Syndrome.

Science.gov (United States)

Sung, Eun Jung; Kim, Dae Yul; Chang, Min Cheol; Ko, Eun Jae

2016-06-01

To identify the factors that could predict the functional outcome in patients with the axonal type of Guillain-Barre syndrome (GBS). Two hundred and two GBS patients admitted to our university hospital between 2003 and 2014 were reviewed retrospectively. We defined a good outcome as being "able to walk independently at 1 month after onset" and a poor outcome as being "unable to walk independently at 1 month after onset". We evaluated the factors that differed between the good and poor outcome groups. Twenty-four patients were classified into the acute motor axonal neuropathy type. There was a statistically significant difference between the good and poor outcome groups in terms of the GBS disability score at admission, and GBS disability score and Medical Research Council sum score at 1 month after admission. In an electrophysiologic analysis, the good outcome group showed greater amplitude of median, ulnar, deep peroneal, and posterior tibial nerve compound muscle action potentials (CMAP) and greater amplitude of median, ulnar, and superficial peroneal sensory nerve action potentials (SNAP) than the poor outcome group. A lower GBS disability score at admission, high amplitude of median, ulnar, deep peroneal, and posterior tibial CMAPs, and high amplitude of median, ulnar, and superficial peroneal SNAPs were associated with being able to walk at 1 month in patients with axonal GBS.

Measuring Learning Outcomes in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

2003-01-01

The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators as well as the accounting profession. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning outcomes......). The study provides evidence, which confirms an interrelationship between declarative and procedural knowledge in auditing, and the findings also suggest that students with auditing experience perform better than students without experience on procedural questions....

Digital Storytelling as Poetic Reflection in Occupational Therapy Education: An Empirical Study

Directory of Open Access Journals (Sweden)

Lisebet S. Skarpaas

2016-07-01

Full Text Available Stories are powerful aids to reflection. Thus, the use of stories may be a pathway to enhanced reflective practice and clinical reasoning skills. The aim of this study was to evaluate whether and how digital storytelling can contribute to occupational therapy (OT students’ learning through reflections on experiences from placement education. A cohort of OT students (n = 57 participated in a 2-day workshop to create digital stories. Data were generated through a questionnaire with a response rate of 100% of students who completed the workshop (n = 34. Quantitative analysis methods were used to reveal a level of agreement in the questionnaire statements, and qualitative content analysis was performed for the open-ended questions. The results show that the students learned through reflection on placement experiences in the digital storytelling process as they emphasized reflection as a main outcome. They highlighted the importance of sharing thoughts and reflections with peers. The students confirmed that this happens through the creative process and the use of multimodality in poetic reflection, but they were less convinced by the use of the narrative approach as a dramatic structure. The students experienced reflection and sharing as important elements in the digital storytelling process. However, investigations are needed into the use of a narrative approach to enhance reflection with larger cohorts as well as more thematic analyses.

A missing ethical competency? A review of critical reflection in health promotion.

Science.gov (United States)

Tretheway, Rebecca; Taylor, Jane; O'Hara, Lily; Percival, Nikki

2015-12-01

There is increasing emphasis in the health promotion literature on the ethical imperative for the profession to move towards critical practice. A key challenge for health promotion is that critical practice appears both under-developed and under-practiced. This is evident in the omission of critical reflection from Australian and international competencies for health promotion practitioners. A narrative literature review was undertaken to explore the current use of critical reflection in health promotion. Critical reflection models relevant to health promotion were identified and critiqued. There was a dearth of literature on critical reflection within health promotion, despite recognition of its potential to support critical practice. The discipline of critical social work provided literature on the use, effect and outcome of critical reflection in practice. The interdisciplinary critical reflection model was identified as the model most applicable to health promotion. Underpinned by critical theory, this model emphasises both critical and ethical practice. Critical reflection is a core competency for health promotion practitioners to address the ethical imperative to move towards critical practice. There is a need to explore the application of a critical reflection model in health promotion to determine how it may support critical and ethical practice. So what? If health promotion is to meet its ethical responsibilities, then critical reflection needs to be articulated as a core health promotion competency and a model for its application in health promotion developed.

Associations Between Participant Ratings of PREP for Strong Bonds and Marital Outcomes 1 Year Postintervention.

Science.gov (United States)

Allen, Elizabeth S; Post, Kristina M; Markman, Howard J; Rhoades, Galena K; Stanley, Scott M

2017-07-01

After completing a relationship education program, collecting participant evaluations of the program is common practice. These are generally used as an index of "consumer satisfaction" with the program, with implications for feasibility and quality. Rarely have these ratings been used as predictors of changes in marital quality, although such feedback may be the only data providers collect or have immediate access to when considering the success of their efforts. To better understand the utility of such ratings to predict outcomes, we evaluated links between participant ratings and changes in self-reported marital satisfaction and communication scores one year later for a sample of 191 Army couples who had participated in a relationship education program delivered by Army chaplains (PREP for Strong Bonds). Overall ratings of general satisfaction with the program and the leader did not predict changes in marital outcomes one year later, whereas higher ratings of how much was learned, program helpfulness, increased similarity in outlook regarding Army life, and helpfulness of communication skills training predicted greater change in communication skills one year later. Higher ratings of items reflecting intent to invest more time in the relationship, and increased confidence in constructive communication and working as a team with the spouse predicted greater increases in both marital satisfaction and communication skills one year later. The constructs of intention and confidence (akin to perceived behavioral control) suggest that the Theory of Planned Behavior may be particularly useful when considering which Army couples will show ongoing benefit after relationship education.

Experiences of self-practice/self-reflection in cognitive behavioural therapy: a meta-synthesis of qualitative studies.

Science.gov (United States)

Gale, Corinne; Schröder, Thomas

2014-12-01

Self-practice/self-reflection is a valuable training strategy which involves therapists applying therapeutic techniques to themselves, and reflecting on the process. To undertake a meta-synthesis of qualitative studies exploring therapists' experiences of self-practice/self-reflection in cognitive behavioural therapy (CBT). This would integrate, and interpret, the current literature in order to develop a new understanding, and contribute to the development of CBT training programmes. The meta-synthesis encompassed three distinct phases: undertaking a comprehensive and systematic literature search; critically appraising the papers; and synthesising the data using the meta-ethnographic method. The literature search identified 378 papers, ten met the criteria for inclusion. After critical appraisal, all were included in the synthesis. The synthesis identified 14 constructs, which fell into three broad categories: 'experience of self-practice/self-reflection'; 'outcomes of self-practice/self-reflection'; and 'implications for training'. This synthesis found that self-practice allows therapists to put themselves into their clients' shoes, experiencing the benefits that therapy can bring but also the problems that clients can run in to. This experience increases therapists' empathy for their clients, allowing them to draw on their own experiences in therapy. As a result, therapists tend to feel both more confident in themselves and more competent as a therapist. The self-practice/self-reflection process was facilitated by reflective writing and working with others, particularly peers. Self-practice/self-reflection is a valuable training strategy in CBT, which has a range of beneficial outcomes. It can also be used as a means of continuing personal and professional development. Self-practice of CBT techniques, and reflecting on the process, can be a useful training strategy and helpful for ongoing development Therapists could consider developing a 'self-case' study

Transparency of Outcome Reporting and Trial Registration of Randomized Controlled Trials Published in the Journal of Consulting and Clinical Psychology.

Science.gov (United States)

Azar, Marleine; Riehm, Kira E; McKay, Dean; Thombs, Brett D

2015-01-01

Confidence that randomized controlled trial (RCT) results accurately reflect intervention effectiveness depends on proper trial conduct and the accuracy and completeness of published trial reports. The Journal of Consulting and Clinical Psychology (JCCP) is the primary trials journal amongst American Psychological Association (APA) journals. The objectives of this study were to review RCTs recently published in JCCP to evaluate (1) adequacy of primary outcome analysis definitions; (2) registration status; and, (3) among registered trials, adequacy of outcome registrations. Additionally, we compared results from JCCP to findings from a recent study of top psychosomatic and behavioral medicine journals. Eligible RCTs were published in JCCP in 2013-2014. For each RCT, two investigators independently extracted data on (1) adequacy of outcome analysis definitions in the published report, (2) whether the RCT was registered prior to enrolling patients, and (3) adequacy of outcome registration. Of 70 RCTs reviewed, 12 (17.1%) adequately defined primary or secondary outcome analyses, whereas 58 (82.3%) had multiple primary outcome analyses without statistical adjustment or undefined outcome analyses. There were 39 (55.7%) registered trials. Only two trials registered prior to patient enrollment with a single primary outcome variable and time point of assessment. However, in one of the two trials, registered and published outcomes were discrepant. No studies were adequately registered as per Standard Protocol Items: Recommendation for Interventional Trials guidelines. Compared to psychosomatic and behavioral medicine journals, the proportion of published trials with adequate outcome analysis declarations was significantly lower in JCCP (17.1% versus 32.9%; p = 0.029). The proportion of registered trials in JCCP (55.7%) was comparable to behavioral medicine journals (52.6%; p = 0.709). The quality of published outcome analysis definitions and trial registrations in JCCP is

Transparency of Outcome Reporting and Trial Registration of Randomized Controlled Trials Published in the Journal of Consulting and Clinical Psychology.

Directory of Open Access Journals (Sweden)

Marleine Azar

Full Text Available Confidence that randomized controlled trial (RCT results accurately reflect intervention effectiveness depends on proper trial conduct and the accuracy and completeness of published trial reports. The Journal of Consulting and Clinical Psychology (JCCP is the primary trials journal amongst American Psychological Association (APA journals. The objectives of this study were to review RCTs recently published in JCCP to evaluate (1 adequacy of primary outcome analysis definitions; (2 registration status; and, (3 among registered trials, adequacy of outcome registrations. Additionally, we compared results from JCCP to findings from a recent study of top psychosomatic and behavioral medicine journals.Eligible RCTs were published in JCCP in 2013-2014. For each RCT, two investigators independently extracted data on (1 adequacy of outcome analysis definitions in the published report, (2 whether the RCT was registered prior to enrolling patients, and (3 adequacy of outcome registration.Of 70 RCTs reviewed, 12 (17.1% adequately defined primary or secondary outcome analyses, whereas 58 (82.3% had multiple primary outcome analyses without statistical adjustment or undefined outcome analyses. There were 39 (55.7% registered trials. Only two trials registered prior to patient enrollment with a single primary outcome variable and time point of assessment. However, in one of the two trials, registered and published outcomes were discrepant. No studies were adequately registered as per Standard Protocol Items: Recommendation for Interventional Trials guidelines. Compared to psychosomatic and behavioral medicine journals, the proportion of published trials with adequate outcome analysis declarations was significantly lower in JCCP (17.1% versus 32.9%; p = 0.029. The proportion of registered trials in JCCP (55.7% was comparable to behavioral medicine journals (52.6%; p = 0.709.The quality of published outcome analysis definitions and trial registrations in JCCP is

Greater-confinement disposal

International Nuclear Information System (INIS)

Trevorrow, L.E.; Schubert, J.P.

1989-01-01

Greater-confinement disposal (GCD) is a general term for low-level waste (LLW) disposal technologies that employ natural and/or engineered barriers and provide a degree of confinement greater than that of shallow-land burial (SLB) but possibly less than that of a geologic repository. Thus GCD is associated with lower risk/hazard ratios than SLB. Although any number of disposal technologies might satisfy the definition of GCD, eight have been selected for consideration in this discussion. These technologies include: (1) earth-covered tumuli, (2) concrete structures, both above and below grade, (3) deep trenches, (4) augered shafts, (5) rock cavities, (6) abandoned mines, (7) high-integrity containers, and (8) hydrofracture. Each of these technologies employ several operations that are mature,however, some are at more advanced stages of development and demonstration than others. Each is defined and further described by information on design, advantages and disadvantages, special equipment requirements, and characteristic operations such as construction, waste emplacement, and closure

Functional Outcome After Antegrade Femoral Nailing : A Comparison of Trochanteric Fossa Versus Tip of Greater Trochanter Entry Point

NARCIS (Netherlands)

Moein, Chloe Ansari; ten Duis, Henk-Jan; Oey, Liam; de Kort, Gerard; van der Meulen, Wout; Vermeulen, Karin; van der Werken, Christiaan

Objectives: This study was performed to explore the relationship between entry point-related soft tissue damage in antegrade femoral nailing and the functional outcome in patients with a proximal third femoral shaft fracture. Design: Retrospective clinical trial. Setting: Level I university trauma

Stigma Resistance in Stable Schizophrenia: The Relative Contributions of Stereotype Endorsement, Self-Reflection, Self-Esteem, and Coping Styles.

Science.gov (United States)

Kao, Yu-Chen; Lien, Yin-Ju; Chang, Hsin-An; Tzeng, Nian-Sheng; Yeh, Chin-Bin; Loh, Ching-Hui

2017-10-01

Stigma resistance (SR) has recently emerged as a prominent aspect of research on recovery from schizophrenia, partly because studies have suggested that the development of stigma-resisting beliefs may help individuals lead a fulfilling life and recover from their mental illness. The present study assessed the relationship between personal SR ability and prediction variables such as self-stigma, self-esteem, self-reflection, coping styles, and psychotic symptomatology. We performed an exploratory cross-sectional study of 170 community-dwelling patients with schizophrenia. Self-stigma, self-esteem, self-reflection, coping skills, and SR were assessed through self-report. Psychotic symptom severity was rated by the interviewers. Factors showing significant association in univariate analyses were included in a stepwise backward regression model. Stepwise regressions revealed that acceptance of stereotypes of mental illness, self-esteem, self-reflection, and only 2 adaptive coping strategies (positive reinterpretation and religious coping) were significant predictors of SR. The prediction model accounted for 27.1% of the variance in the SR subscale score in our sample. Greater reflective capacity, greater self-esteem, greater preferences for positive reinterpretation and religious coping, and fewer endorsements of the stereotypes of mental illness may be key factors that relate to higher levels of SR. These factors are potentially modifiable in tailored interventions, and such modification may produce considerable improvements in the SR of the investigated population. This study has implications for psychosocial rehabilitation and emerging views of recovery from mental illness.

Being a reflective teacher——reflection on group management

Institute of Scientific and Technical Information of China (English)

Pan; Lehui

2015-01-01

<正>Introduction According to Pollard and Triggs(1997),reflective teaching is a process through which the capacity to make such professional judgments can be developed and maintained.Then what is a reflective teacher?Reflective teacher is someone who reflects systematically on her practice in a constant attempt to improve

Using an Intention/Reflection Practice to Focus Students towards Future Professions in a Short-Term International Travel Experience

Science.gov (United States)

Fierke, Kerry K.; Lepp, Gardner A.; Bastianelli, Karen; Vogelsang, Lisa; Tornabene, Ladona

2016-01-01

The article describes a student-centered approach to generating meaningful learning outcomes in a short-term study abroad program. A practice named Intention/Reflection (I/R) was used to help students to identify, articulate, and reflect upon learning objectives that were personally meaningful, within the broader framework of the intended outcomes…

Ethics Leadership in Research, Healthcare and Organizational Systems: Commentary and Critical Reflections

Science.gov (United States)

Gabriele, Edward F.

2011-01-01

In the last decades there has arisen a greater awareness of the ever present need for critical academic reflection on the nature of ethics leadership and committees in research, healthcare, and organizational systems. Yet what is meant by ethics itself? How is ethics understood as a historical phenomenon? What challenges must ethics leaders face…

Intrinsic motivation as a predictor of work outcome after vocational rehabilitation in schizophrenia.

Science.gov (United States)

Saperstein, Alice M; Fiszdon, Joanna M; Bell, Morris D

2011-09-01

Intrinsic motivation is a construct commonly used in explaining goal-directed behavior. In people with schizophrenia, intrinsic motivation is usually subsumed as a feature of negative symptoms or underlying neurocognitive dysfunction. A growing literature reflects an interest in defining and measuring motivational impairment in schizophrenia and in delineating the specific role of intrinsic motivation as both an independent predictor and a mediator of psychosocial functioning. This cross-sectional study examined intrinsic motivation as a predictor of vocational outcomes for 145 individuals with schizophrenia and schizoaffective disorder participating in a 6-month work rehabilitation trial. Correlation and mediation analyses examined baseline intrinsic motivation and negative symptoms in relation to work hours and work performance. Data support a significant relationship between intrinsic motivation and negative symptoms and significant correlations with outcome variables, such that lower negative symptoms and greater intrinsic motivation were associated with better work functioning. Moreover, in this sample, intrinsic motivation fully mediated the relationships between negative symptoms, work productivity, and work performance. These results have significant implications on the design of work rehabilitation interventions for people with schizophrenia and support a role for targeting intrinsic motivation directly to influence vocational functioning. Future directions for research and intervention are discussed.

Learning outcomes for communication skills across the health professions: a systematic literature review and qualitative synthesis.

Science.gov (United States)

Denniston, Charlotte; Molloy, Elizabeth; Nestel, Debra; Woodward-Kron, Robyn; Keating, Jennifer L

2017-04-07

The aim of this study was to identify and analyse communication skills learning outcomes via a systematic review and present results in a synthesised list. Summarised results inform educators and researchers in communication skills teaching and learning across health professions. Systematic review and qualitative synthesis. A systematic search of five databases (MEDLINE, PsycINFO, ERIC, CINAHL plus and Scopus), from first records until August 2016, identified published learning outcomes for communication skills in health professions education. Extracted data were analysed through an iterative process of qualitative synthesis. This process was guided by principles of person centredness and an a priori decision guide. 168 papers met the eligibility criteria; 1669 individual learning outcomes were extracted and refined using qualitative synthesis. A final refined set of 205 learning outcomes were constructed and are presented in 4 domains that include: (1) knowledge (eg, describe the importance of communication in healthcare), (2) content skills (eg, explore a healthcare seeker's motivation for seeking healthcare),( 3) process skills (eg, respond promptly to a communication partner's questions) and (4) perceptual skills (eg, reflect on own ways of expressing emotion). This study provides a list of 205 communication skills learning outcomes that provide a foundation for further research and educational design in communication education across the health professions. Areas for future investigation include greater patient involvement in communication skills education design and further identification of learning outcomes that target knowledge and perceptual skills. This work may also prompt educators to be cognisant of the quality and scope of the learning outcomes they design and their application as goals for learning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Becoming Reflective and Inquiring Teachers: Collaborative Action Research for In-service Chilean Teachers

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Martine Pellerin

2015-08-01

Full Text Available This article discusses the outcomes of a case study that engaged Chilean in-service teachers in systematic action research (AR as a means of improving their pedagogical practice and effecting changes in their educational context. The study involved six in-service teachers from a region of Chile and two university researchers. The findings show that knowledge of systematic AR provided the teachers with the necessary means to engage in a critical reflection and inquiry process regarding their own practice. The teacher participants also perceived the self-reflective spiral of reflection and action to be crucial in establishing new habits of inquiry and reflection about their own pedagogical actions. The findings support earlier studies (e.g., Price & Valli, 2005; Steven & Kitchen, 2005, 2011 concerning the necessity of including knowledge of systematic AR in teacher preparation programs in order to foster strong habits of inquiry and reflection among preservice teachers. Finally, the study suggests that participation in a systematic reflection and inquiry process contributes to empowering in-service teachers to become agents of pedagogical change through their own actions.

Consistencies far beyond chance: an analysis of learner preconceptions of reflective symmetry

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Michael Kainose Mhlolo

2013-01-01

Full Text Available This article reports on regularities observed in learners' preconceptions of reflective symmetry. Literature suggests that the very existence of such regularities indicates a gap between what learners know and what they need to know. Such a gap inhibits further understanding and application, and hence needed to be investigated. A total of 235 Grade 11 learners, from 13 high schools that participate in the First Rand Foundation-funded Mathematics Education project in the Eastern Cape, responded to a task on reflective symmetry. Our framework for analysing the responses was based on the taxonomy of structure of the observed learning outcome. The results indicated that 85% of learner responses reflect a motion understanding of reflections, where learners considered geometric figures as physical motions on top of the plane. While this understanding is useful in some cases, it is not an essential aspect of mapping understanding, which is critical for application in function notations and other analytical geometry contexts. We suggest that if this gap is to be closed, learners need to construct these reflections physically so that they may think of reflections beyond motion.

Ischemic stroke subtype is associated with outcome in thrombolyzed patients

DEFF Research Database (Denmark)

Schmitz, Marie Louise; Simonsen, Claus Ziegler; Svendsen, M L

2017-01-01

OBJECTIVES: The impact of ischemic stroke subtype on clinical outcome in patients treated with intravenous tissue-type plasminogen activator (IV-tPA) is sparsely examined. We studied the association between stroke subtype and clinical outcome in magnetic resonance imaging (MRI)-evaluated patients...... patients were more likely to achieve early neurological improvement and favorable outcome compared with LVD stroke following MRI-based IV-tPA treatment. This finding may reflect a difference in the effect of IV-tPA among stroke subtypes....

Maintained intentional weight loss reduces cardiovascular outcomes: results from the Sibutramine Cardiovascular OUTcomes (SCOUT) trial.

Science.gov (United States)

Caterson, I D; Finer, N; Coutinho, W; Van Gaal, L F; Maggioni, A P; Torp-Pedersen, C; Sharma, A M; Legler, U F; Shepherd, G M; Rode, R A; Perdok, R J; Renz, C L; James, W P T

2012-06-01

The Sibutramine Cardiovascular OUTcomes trial showed that sibutramine produced greater mean weight loss than placebo but increased cardiovascular morbidity but not mortality. The relationship between 12-month weight loss and subsequent cardiovascular outcomes is explored. Overweight/obese subjects (N = 10 744), ≥55 years with cardiovascular disease and/or type 2 diabetes mellitus, received sibutramine plus weight management during a 6-week Lead-in Period before randomization to continue sibutramine (N = 4906) or to receive placebo (N = 4898). The primary endpoint was the time from randomization to first occurrence of a primary outcome event (non-fatal myocardial infarction, non-fatal stroke, resuscitated cardiac arrest or cardiovascular death). For the total population, mean weight change during Lead-in Period (sibutramine) was -2.54 kg. Post-randomization, mean total weight change to Month 12 was -4.18 kg (sibutramine) or -1.87 kg (placebo). Degree of weight loss during Lead-in Period or through Month 12 was associated with a progressive reduction in risk for the total population in primary outcome events and cardiovascular mortality over the 5-year assessment. Although more events occurred in the randomized sibutramine group, on an average, a modest weight loss of approximately 3 kg achieved in the Lead-in Period appeared to offset this increased event rate. Moderate weight loss (3-10 kg) reduced cardiovascular deaths in those with severe, moderate or mild cardiovascular disease. Modest weight loss over short-term (6 weeks) and longer-term (6-12 months) periods is associated with reduction in subsequent cardiovascular mortality for the following 4-5 years even in those with pre-existing cardiovascular disease. While the sibutramine group experienced more primary outcome events than the placebo group, greater weight loss reduced overall risk of these occurring in both groups. © 2011 Blackwell Publishing Ltd.

Measuring Learning Outcomes. A Learner Perspective in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

2000-01-01

The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... for students taking a graduate auditing course reflect prior accounting work experience for some students and undergraduate accounting coursework experience for all students. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning...... suggested by Robert M. Gagné. An instrument was developed to measure differences regarding learning outcomes in the context of an auditing course by posing a broad set of questions testing declarative knowledge and the full range of intellectual skills from discrimination to the use of higher...

Students' Reflections on Industry Placement: Comparing Four Undergraduate Work-Integrated Learning Streams

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Hughes, Karen; Mylonas, Aliisa; Benckendorff, Pierre

2013-01-01

This paper compares four work-integrated learning (WIL) streams embedded in a professional Development course for tourism, hospitality and event management students. Leximancer was used to analyze key themes emerging from reflective portfolios completed by the 137 students in the course. Results highlight that student learning outcomes and…

External Financial Aid to Blood Transfusion Services in Sub-Saharan Africa: A Need for Reflection

NARCIS (Netherlands)

Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda; Boukef, Kamel; Boulton, Frank; Brandful, James; Dax, Elizabeth M.; El Ekiaby, Magdy; Farrugia, Albert; Gorlin, Jed; Hassall, Oliver; Lee, Helen; Loua, André; Maitland, Kathryn; Mbanya, Dora; Mukhtar, Zainab; Murphy, William; Opare-Sem, Ohene; Owusu-Ofori, Shirley; Reesink, Henk; Roberts, David; Torres, Oscar; Totoe, Grace; Ullum, Henrik; Wendel, Silvano

2012-01-01

Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking

External Financial Aid to Blood Transfusion Services in Sub-Saharan Africa: A Need for Reflection

OpenAIRE

Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda; Boukef, Kamel; Boulton, Frank; Brandful, James; Dax, Elizabeth M.; El Ekiaby, Magdy; Farrugia, Albert; Gorlin, Jed; Hassall, Oliver; Lee, Helen; Loua, André; Maitland, Kathryn; Mbanya, Dora

2012-01-01

Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.

The Greater Caucasus Glacier Inventory (Russia, Georgia and Azerbaijan)

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Tielidze, Levan G.; Wheate, Roger D.

2018-01-01

There have been numerous studies of glaciers in the Greater Caucasus, but none that have generated a modern glacier database across the whole mountain range. Here, we present an updated and expanded glacier inventory at three time periods (1960, 1986, 2014) covering the entire Greater Caucasus. Large-scale topographic maps and satellite imagery (Corona, Landsat 5, Landsat 8 and ASTER) were used to conduct a remote-sensing survey of glacier change, and the 30 m resolution Advanced Spaceborne Thermal Emission and Reflection Radiometer Global Digital Elevation Model (ASTER GDEM; 17 November 2011) was used to determine the aspect, slope and height distribution of glaciers. Glacier margins were mapped manually and reveal that in 1960 the mountains contained 2349 glaciers with a total glacier surface area of 1674.9 ± 70.4 km2. By 1986, glacier surface area had decreased to 1482.1 ± 64.4 km2 (2209 glaciers), and by 2014 to 1193.2 ± 54.0 km2 (2020 glaciers). This represents a 28.8 ± 4.4 % (481 ± 21.2 km2) or 0.53 % yr-1 reduction in total glacier surface area between 1960 and 2014 and an increase in the rate of area loss since 1986 (0.69 % yr-1) compared to 1960-1986 (0.44 % yr-1). Glacier mean size decreased from 0.70 km2 in 1960 to 0.66 km2 in 1986 and to 0.57 km2 in 2014. This new glacier inventory has been submitted to the Global Land Ice Measurements from Space (GLIMS) database and can be used as a basis data set for future studies.

Outcome of spinal cord injuries managed in a centre without modern ...

African Journals Online (AJOL)

BACKGROUND: The paucity of published reports from West Africa on the outcome of spinal cord injuries (SCI) reflects the limitations of the developing health care delivery system in this part of the world. OBJECTIVE: To review the outcome of the spinal cord injuries managed in our centre and relate same to those of ...

A Three-Year Reflective Writing Program as Part of Introductory Pharmacy Practice Experiences

Science.gov (United States)

Vaughn, Jessica; Kerr, Kevin; Zielenski, Christopher; Toppel, Brianna; Johnson, Lauren; McCauley, Patrina; Turner, Christopher J.

2013-01-01

Objectives. To implement and evaluate a 3-year reflective writing program incorporated into introductory pharmacy practice experiences (IPPEs) in the first- through third-year of a doctor of pharmacy (PharmD) program. Design. Reflective writing was integrated into 6 IPPE courses to develop students’ lifelong learning skills. In their writing, students were required to self-assess their performance in patient care activities, identify and describe how they would incorporate learning opportunities, and then evaluate their progress. Practitioners, faculty members, and fourth-year PharmD students served as writing preceptors. Assessment. The success of the writing program was assessed by reviewing class performance and surveying writing preceptor’s opinions regarding the student’s achievement of program objectives. Class pass rates averaged greater than 99% over the 8 years of the program and the large majority of the writing preceptors reported that student learning objectives were met. A support pool of 99 writing preceptors was created. Conclusions. A 3-year reflective writing program improved pharmacy students’ reflection and reflective writing skills. PMID:23788811

Simultaneous bilateral isolated greater trochanter fracture

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Maruti Kambali

2013-01-01

Full Text Available A 48-year-old woman sustained simultaneous isolated bilateral greater trochanteric fracture, following a road traffic accident. The patient presented to us 1 month after the injury. She presented with complaints of pain in the left hip and inability to walk. Roentgenograms revealed displaced comminuted bilateral greater trochanter fractures. The fracture of the left greater trochanter was reduced and fixed internally using the tension band wiring technique. The greater trochanter fracture on the right side was asymptomatic and was managed conservatively. The patient regained full range of motion and use of her hips after a postoperative follow-up of 6 months. Isolated fractures of the greater trochanter are unusual injuries. Because of their relative rarity and the unsettled controversy regarding their etiology and pathogenesis, several methods of treatment have been advocated. Furthermore, the reports of this particular type of injury are not plentiful and the average textbook coverage afforded to this entity is limited. In our study we discuss the mechanism of injury and the various treatment options available.

Spontaneous Intracerebral Hemorrhage: Computed Tomographic Characteristics and Outcome

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Aimara de la Caridad Vergara Santos

2015-12-01

Full Text Available Background: strokes are the third leading cause of death among adults and 10-15 % of them are due to spontaneous intracerebral hemorrhage. Objective: to characterize spontaneous intracerebral hemorrhage through computed tomography scan and its outcome. Methods: a case series study was conducted comprising patients diagnosed with spontaneous intracerebral hemorrhage admitted to the Arnaldo Milián Castro Provincial University Hospital in Villa Clara from January 2009 to January 2010. Tomographic variables of interest were derived from evaluation of spontaneous intracerebral hematomas. Results: fifty-nine cases of spontaneous intracerebral hemorrhage were studied, 23 were located in lobar regions, 4 had severe midline shift, and 2 showed volume greater than 80 ml. Eight out of eleven with extension into the ventricular system had an unfavorable outcome. Among those with thalamic hemorrhage, patients with diameter larger than 4cm and extension into the ventricular system died. Patients with putaminal hemorrhage larger than 4 cm and posterior fossa hematoma with hydrocephalus had a poor outcome, as well as most individuals (55 with other mass effects. Most lobar hematomas (14 out of 23 had a satisfactory outcome, unlike cerebellar and brainstem hematomas. Conclusions: tomographic variables that had a negative impact on the outcome were: volume greater than 80 ml, severe midline shift, diameter larger than 4 cm, extension into the ventricular system, hydrocephalus, other signs of mass effect and brainstem location.

Ethnicity moderates the outcomes of self-enhancement and self-improvement themes in expressive writing.

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Tsai, William; Lau, Anna S; Niles, Andrea N; Coello, Jordan; Lieberman, Matthew D; Ko, Ahra C; Hur, Christopher; Stanton, Annette L

2015-10-01

The current study examined whether writing content related to self-enhancing (viz., downward social comparison and situational attributions) and self-improving (viz., upward social comparison and persistence) motivations were differentially related to expressive writing outcomes among 17 Asian American and 17 European American participants. Content analysis of the essays revealed no significant cultural group differences in the likelihood of engaging in self-enhancing versus self-improving reflections on negative personal experiences. However, cultural group differences were apparent in the relation between self-motivation processes and changes in anxiety and depressive symptoms at 3-month follow-up. Among European Americans, writing that reflected downward social comparison predicted positive outcomes, whereas persistence writing themes were related to poorer outcomes. For Asian Americans, writing about persistence was related to positive outcomes, whereas downward social comparison and situational attributions predicted poorer outcomes. Findings provide evidence suggesting culturally distinct mechanisms for the effects of expressive disclosure. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Reflection on the Use of Blended Learning at a Korean University

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Klemsen, Katie Mae; Seong, Myeong Hee

2012-01-01

The purpose of this study was to examine students' satisfaction and investigate the potential of improved learning outcomes in smart and blended learning environments. This paper reflects on the experience of the delivery of a program at H University in Seoul, Korea using smart and blended learning. The goal was to apply the findings to current…

Using artistic-narrative to stimulate reflection on physician bias.

Science.gov (United States)

Ross, Paula T; Lypson, Monica L

2014-01-01

Physician bias toward patients directly impacts patient care and health outcomes. However, too little research has been done investigating avenues to bring about self-awareness in this area to eliminate commonly held stereotypes that fuel physician bias. The purpose of this study was to explore the ways in which 2nd-year medical students' reflected on an artistic-narrative presentation given by a woman with sickle cell disease. A total of 320 2nd-year medical student essays were reviewed for content relevant to the artistic-narrative presentation. A total of 75 essays were identified and served as the data for this study. These 75 essays were analyzed using qualitative interpretive thematic content analysis to identify students' perceptions and reflections on culture in the healthcare environment and the patient-provider relationship. The analysis of the reflective essays revealed that this exercise helped students acknowledge physician bias in pain treatment, foster empathetic views toward patients as individuals, and recognize various ways in which biased beliefs can provide incite in healthcare disparities. These findings suggest that the combination of methods--art, narrative, and written reflection--helped students acknowledge their own bias as well as the ways in which taken-for-granted assumptions and biases can influence patient care.

Interactions of solitons in Bragg gratings with dispersive reflectivity in a cubic-quintic medium

Science.gov (United States)

Dasanayaka, Sahan; Atai, Javid

2011-08-01

Interactions between quiescent solitons in Bragg gratings with cubic-quintic nonlinearity and dispersive reflectivity are systematically investigated. In a previous work two disjoint families of solitons were identified in this model. One family can be viewed as the generalization of the Bragg grating solitons in Kerr nonlinearity with dispersive reflectivity (Type 1). On the other hand, the quintic nonlinearity is dominant in the other family (Type 2). For weak to moderate dispersive reflectivity, two in-phase solitons will attract and collide. Possible collision outcomes include merger to form a quiescent soliton, formation of three solitons including a quiescent one, separation after passing through each other once, asymmetric separation after several quasielastic collisions, and soliton destruction. Type 2 solitons are always destroyed by collisions. Solitons develop sidelobes when dispersive reflectivity is strong. In this case, it is found that the outcome of the interactions is strongly dependent on the initial separation of solitons. Solitons with sidelobes will collide only if they are in-phase and their initial separation is below a certain critical value. For larger separations, both in-phase and π-out-of-phase Type 1 and Type 2 solitons may either repel each other or form a temporary bound state that subsequently splits into two separating solitons. Additionally, in the case of Type 2 solitons, for certain initial separations, the bound state disintegrates into a single moving soliton.

Prospect theory reflects selective allocation of attention.

Science.gov (United States)

Pachur, Thorsten; Schulte-Mecklenbeck, Michael; Murphy, Ryan O; Hertwig, Ralph

2018-02-01

There is a disconnect in the literature between analyses of risky choice based on cumulative prospect theory (CPT) and work on predecisional information processing. One likely reason is that for expectation models (e.g., CPT), it is often assumed that people behaved only as if they conducted the computations leading to the predicted choice and that the models are thus mute regarding information processing. We suggest that key psychological constructs in CPT, such as loss aversion and outcome and probability sensitivity, can be interpreted in terms of attention allocation. In two experiments, we tested hypotheses about specific links between CPT parameters and attentional regularities. Experiment 1 used process tracing to monitor participants' predecisional attention allocation to outcome and probability information. As hypothesized, individual differences in CPT's loss-aversion, outcome-sensitivity, and probability-sensitivity parameters (estimated from participants' choices) were systematically associated with individual differences in attention allocation to outcome and probability information. For instance, loss aversion was associated with the relative attention allocated to loss and gain outcomes, and a more strongly curved weighting function was associated with less attention allocated to probabilities. Experiment 2 manipulated participants' attention to losses or gains, causing systematic differences in CPT's loss-aversion parameter. This result indicates that attention allocation can to some extent cause choice regularities that are captured by CPT. Our findings demonstrate an as-if model's capacity to reflect characteristics of information processing. We suggest that the observed CPT-attention links can be harnessed to inform the development of process models of risky choice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Physiotherapy and low back pain - part 1 outcomes research in the quest for evidence

Directory of Open Access Journals (Sweden)

L. D. Bardin

2002-01-01

conditions treated by physiotherapists and is acknowledged as a major health problem. Much published research on LBP is of poor design and  optimal outcome measures are not selected for LBP patients. Effective and cost-effective interventions for LBP, particularly chronic LBP, need to be identified using appropriate, valid, reliable and responsive measures of  outcome.  These outcome measures should reflect the biopsychosocial model necessary for evaluating the broad impact of LBP, in particular chronic LBP, on a patient’s life. Outcomes research is a feasible and affordable analysis of clinical practice as it occurs, and provides an opportunity to evaluate the effectiveness of interventions for LBP. This is in contrast to a randomised, controlled trial (RCT that evaluates efficacy under controlled conditions that often do not reflect clinical practice. Using a battery of outcome measures appropriate for measuring change in the LBP population, outcomes research has the potential to identify effective and cost-effective interventions, promote and influence further research, and contribute to the demand for evidence-based practice.

Reflective photovoltaics

Energy Technology Data Exchange (ETDEWEB)

Lentine, Anthony L.; Nielson, Gregory N.; Cruz-Campa, Jose Luis; Okandan, Murat; Goeke, Ronald S.

2018-03-06

A photovoltaic module includes colorized reflective photovoltaic cells that act as pixels. The colorized reflective photovoltaic cells are arranged so that reflections from the photovoltaic cells or pixels visually combine into an image on the photovoltaic module. The colorized photovoltaic cell or pixel is composed of a set of 100 to 256 base color sub-pixel reflective segments or sub-pixels. The color of each pixel is determined by the combination of base color sub-pixels forming the pixel. As a result, each pixel can have a wide variety of colors using a set of base colors, which are created, from sub-pixel reflective segments having standard film thicknesses.

Trait anxiety and impaired control of reflective attention in working memory.

Science.gov (United States)

Hoshino, Takatoshi; Tanno, Yoshihiko

2016-01-01

The present study investigated whether the control of reflective attention in working memory (WM) is impaired in high trait anxiety individuals. We focused on the consequences of refreshing-a simple reflective process of thinking briefly about a just-activated representation in mind-on the subsequent processing of verbal stimuli. Participants performed a selective refreshing task, in which they initially refreshed or read one word from a three-word set, and then refreshed a non-selected item from the initial phrase or read aloud a new word. High trait anxiety individuals exhibited greater latencies when refreshing a word after experiencing the refreshing of a word from the same list of semantic associates. The same pattern was observed for reading a new word after prior refreshing. These findings suggest that high trait anxiety individuals have difficulty resolving interference from active distractors when directing reflective attention towards contents in WM or processing a visually presented word.

Effect of invasive EEG monitoring on cognitive outcome after left temporal lobe epilepsy surgery.

Science.gov (United States)

Busch, Robyn M; Love, Thomas E; Jehi, Lara E; Ferguson, Lisa; Yardi, Ruta; Najm, Imad; Bingaman, William; Gonzalez-Martinez, Jorge

2015-10-27

The objective of this cohort study was to compare neuropsychological outcomes following left temporal lobe resection (TLR) in patients with epilepsy who had or had not undergone prior invasive monitoring. Data were obtained from an institutional review board-approved, neuropsychology registry for patients who underwent epilepsy surgery at Cleveland Clinic between 1997 and 2013. A total of 176 patients (45 with and 131 without invasive EEG) met inclusion criteria. Primary outcome measures were verbal memory and language scores. Other cognitive outcomes were also examined. Outcomes were assessed using difference in scores from before to after surgery and by presence/absence of clinically meaningful decline using reliable change indices (RCIs). Effect of invasive EEG on cognitive outcomes was estimated using weighting and propensity score adjustment to account for differences in baseline characteristics. Linear and logistic regression models compared surgical groups on all cognitive outcomes. Patients with invasive monitoring showed greater declines in confrontation naming; however, when RCIs were used to assess clinically meaningful change, there was no significant treatment effect on naming performance. No difference in verbal memory was observed, regardless of how the outcome was measured. In secondary outcomes, patients with invasive monitoring showed greater declines in working memory, which were no longer apparent using RCIs to define change. There were no outcome differences on other cognitive measures. Results suggest that invasive EEG monitoring conducted prior to left TLR is not associated with greater cognitive morbidity than left TLR alone. This information is important when counseling patients regarding cognitive risks associated with this elective surgery. © 2015 American Academy of Neurology.

Reflection on Lessons Learned: An Analysis of the Adverse Outcomes Observed During the Hurricane Rita Evacuation.

Science.gov (United States)

Baker, Karen

2018-02-01

In September 2005, nearly 3.7 million people evacuated the Texas coastline in advance of Hurricane Rita's landfall, making the event the largest emergency evacuation in US history. The Rita evacuation underscored the importance of planning for domestic mass-evacuation events, as the evacuation itself led to over 100 of the at least 119 deaths attributed to the storm. In the days preceding Rita's landfall, several cascading, interrelated circumstances precipitated such adverse outcomes. This article explores the series of events leading up to the evacuation's poor outcomes, the response following Rita to amend evacuation plans, and how Texas successfully implemented these changes during later storms to achieve better outcomes. (Disaster Med Public Health Preparedness. 2018;12:115-120).

External financial aid to blood transfusion services in sub-Saharan Africa: a need for reflection.

Directory of Open Access Journals (Sweden)

Fereydoun Ala

Full Text Available Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.

The effective reflection of a pulse sequence from a four-wave mirror with thermal nonlinearity under parametric feedback

Science.gov (United States)

Barashkov, M. S.; Bel'Diugin, I. M.; Zolotarev, M. V.; Kruzhilin, Iu. I.; Krymskii, M. I.

1989-04-01

A four-wave mirror with thermal nonlinearity has been experimentally realized with the interaction of corunning waves under parametric feedback with a nonreciprocal element. The effective reflection of a sequence of pulses with duration of about 300 ns from a neodymium-glass laser with maximal reflection coefficients greater than 30 has been demonstrated. The quality of the radiation reflected from the mirror is studied. A significant reduction in the steady-state lasing threshold has been shown with thermal nonlinearity at small angles of the interacting beam convergence, compared to the case of counterrunning convergence.

Development of reflective judgement in the pre-doctoral dental clinical curriculum.

Science.gov (United States)

Boyd, L D

2008-08-01

When dental students begin patient care in the clinical curriculum, they are required to move from the well-defined problems of the classroom to the more ambiguous and real life problems encountered in the context of patient care in the clinical setting. This change in learning environment requires development of reflective thinking. Reflective thinking refers to the process of thinking about uncertainty or ill-defined problems. King and Kitchener refer to the outcome of the reflective thinking process as reflective judgement. The purpose of this study was to explore the development of reflective judgement in the initial phase of the clinical curriculum. This exploratory study used a case study approach with qualitative methods. A convenience sample of third year predoctoral dental students (n = 16) volunteered to participate in writing a clinic journal and semi-structured interviews at three time points over a time period of one year. Student compliance in writing clinical journals was poor; therefore the qualitative data was primarily gathered from interview transcripts. The qualitative interview data were analysed using a coding scheme based on King and Kitchener's Reflective Judgement Model of Intellectual Development. The Cronbach alpha was 0.76 for reliability of the coding scheme. Based on the analysis of interview data, the there was an average growth in reflective judgement over the year from Stage 4.89 to 5.59 for an overall change of +0.70. Additional research is needed to explore the growth in reflective judgement over the final year of the clinical curriculum as well as to identify the most effective educational strategies to facilitate growth in reflective judgment.

Greater physiological and behavioral effects of interrupted stress pattern compared to daily restraint stress in rats.

Directory of Open Access Journals (Sweden)

Wei Zhang

Full Text Available Repeated stress can trigger a range of psychiatric disorders, including anxiety. The propensity to develop abnormal behaviors after repeated stress is related to the severity, frequency and number of stressors. However, the pattern of stress exposure may contribute to the impact of stress. In addition, the anxiogenic nature of repeated stress exposure can be moderated by the degree of coping that occurs, and can be reflected in homotypic habituation to the repeated stress. However, expectations are not clear when a pattern of stress presentation is utilized that diminishes habituation. The purpose of these experiments is to test whether interrupted stress exposure decreases homotypic habituation and leads to greater effects on anxiety-like behavior in adult male rats. We found that repeated interrupted restraint stress resulted in less overall homotypic habituation compared to repeated daily restraint stress. This was demonstrated by greater production of fecal boli and greater corticosterone response to restraint. Furthermore, interrupted restraint stress resulted in a lower body weight and greater adrenal gland weight than daily restraint stress, and greater anxiety-like behavior in the elevated plus maze. Control experiments demonstrated that these effects of the interrupted pattern could not be explained by differences in the total number of stress exposures, differences in the total number of days that the stress periods encompased, nor could it be explained as a result of only the stress exposures after an interruption from stress. These experiments demonstrate that the pattern of stress exposure is a significant determinant of the effects of repeated stress, and that interrupted stress exposure that decreases habituation can have larger effects than a greater number of daily stress exposures. Differences in the pattern of stress exposure are therefore an important factor to consider when predicting the severity of the effects of repeated

Revisiting Darwin's hypothesis: Does greater intraspecific variability increase species' ecological breadth?

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Sides, Colby B; Enquist, Brian J; Ebersole, James J; Smith, Marielle N; Henderson, Amanda N; Sloat, Lindsey L

2014-01-01

Darwin first proposed that species with larger ecological breadth have greater phenotypic variation. We tested this hypothesis by comparing intraspecific variation in specific leaf area (SLA) to species' local elevational range and by assessing how external (abiotic) filters may influence observed differences in ecological breadth among species. Understanding the patterns of individual variation within and between populations will help evaluate differing hypotheses for structuring of communities and distribution of species. We selected 21 species with varying elevational ranges and compared the coefficient of variation of SLA for each species against its local elevational range. We examined the influence of external filters on local trait composition by determining if intraspecific changes in SLA with elevation have the same direction and similar rates of change as the change in community mean SLA value. In support of Darwin's hypothesis, we found a positive relationship between species' coefficient of variation for SLA with species' local elevational range. Intraspecific changes in SLA had the same sign, but generally lower magnitude than the community mean SLA. The results indicate that wide-ranging species are indeed characterized by greater intraspecific variation and that species' phenotypes shift along environmental gradients in the same direction as the community phenotypes. However, across species, the rate of intraspecific trait change, reflecting plastic and/or adaptive changes across populations, is limited and prevents species from adjusting to environmental gradients as quickly as interspecific changes resulting from community assembly.

Network meta-analysis of multiple outcome measures accounting for borrowing of information across outcomes.

Science.gov (United States)

Achana, Felix A; Cooper, Nicola J; Bujkiewicz, Sylwia; Hubbard, Stephanie J; Kendrick, Denise; Jones, David R; Sutton, Alex J

2014-07-21

Network meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes. The standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations. Univariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on

From a distance: implications of spontaneous self-distancing for adaptive self-reflection.

Science.gov (United States)

Ayduk, Ozlem; Kross, Ethan

2010-05-01

Although recent experimental work indicates that self-distancing facilitates adaptive self-reflection, it remains unclear (a) whether spontaneous self-distancing leads to similar adaptive outcomes, (b) how spontaneous self-distancing relates to avoidance, and (c) how this strategy impacts interpersonal behavior. Three studies examined these issues demonstrating that the more participants spontaneously self-distanced while reflecting on negative memories, the less emotional (Studies 1-3) and cardiovascular (Study 2) reactivity they displayed in the short term. Spontaneous self-distancing was also associated with lower emotional reactivity and intrusive ideation over time (Study 1). The negative association between spontaneous self-distancing and emotional reactivity was mediated by how participants construed their experience (i.e., less recounting relative to reconstruing) rather than avoidance (Studies 1-2). In addition, spontaneous self-distancing was associated with more problem-solving behavior and less reciprocation of negativity during conflicts among couples in ongoing relationships (Study 3). Although spontaneous self-distancing was empirically related to trait rumination, it explained unique variance in predicting key outcomes. 2010 APA, all rights reserved

A word-count approach to analyze linguistic patterns in the reflective writings of medical students

Directory of Open Access Journals (Sweden)

Chi-Wei Lin

2016-02-01

�� empathy toward the psychosocial issues faced by patients and their family members, students should be encouraged to explore the domain of psychological processes by identifying and expressing their affective and perceptual experiences. Researchers in future studies should use outcome measures such as self-awareness or empathy to determine the overall effectiveness of reflective writing and how changes in linguistic patterns affect such outcomes.

Commentary: "I hope i'll continue to grow": rubrics and reflective writing in medical education.

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Coulehan, Jack; Granek, Iris A

2012-01-01

One respected tradition in medical education holds that physicians should struggle to maintain sensibility, openness, and compassion in the face of strong contravening tendencies. However, today's medical education is structured around a more recent tradition, which maintains that physicians should struggle to develop emotional detachment as a prerequisite for objectivity. In this model, sensibility and reflective capacity are potentially subversive. Reflective writing is one component of a revisionist approach to medical education that explicitly addresses reflective "habits of the mind" as core competencies and builds on existential concerns voiced by medical students. In response to Wald and colleagues' study, the authors reflect on the role of repeated formative feedback in developing reflective capacity. Formative feedback is as critical in this process as it is in traditional clinical learning. The authors emphasize that well-designed rubrics can assist learners in delineating desired outcomes and teachers in providing appropriate guidance.

Quantifying Reflection

DEFF Research Database (Denmark)

Alcock, Gordon Lindsay

2013-01-01

´ These are all based on Blooms taxonomy and levels of competence and form a major part of individual student and group learning portfolios. Key Words :Project-Based learning, Reflective Portfolios, Self assessment, Defining learning gains, Developing learning strategies , Reflections on and for learning....... It contrasts the students’ self-assessment in a range of ‘product’ skills such as Revit, Structural Design, Mathematics of construction, Technical Installations; as well as ‘process’ competencies such as ‘Working in a team’, Sharing knowledge, Maintaining a portfolio and Reflecting ON learning and FOR learning......This paper documents 1st semester student reflections on “learning to learn” in a team-based PBL environment with quantitative and qualitative student reflective feedback on the learning gains of 60 Architectural Technology and Construction Management students at VIA University College, Denmark...

Systematic review of tools to measure outcomes for young children with autism spectrum disorder

NARCIS (Netherlands)

McConachie, H.; Parr, J.R.; Glod, M.; Hanratty, J.; Livingstone, N.; Oono, I.P.; Robalino, S.; Baird, G.; Beresford, B.; Charman, T.; Garland, D.; Green, J.; Gringras, P.; Jones, G.; Law, J.; Le Couteur, A.S.; Macdonald, G.; McColl, E.M.; Morris, C.; Rodgers, J.; Simonoff, E.; Terwee, C.B.; Williams, K.

2015-01-01

Background: The needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children�s progress. Relevant outcomes include improvement in core ASD impairments, such as

Temperature-reflection I

DEFF Research Database (Denmark)

McGady, David A.

2017-01-01

-temperature path integrals for quantum field theories (QFTs) should be T-reflection invariant. Because multi-particle partition functions are equal to Euclidean path integrals for QFTs, we expect them to be T-reflection invariant. Single-particle partition functions though are often not invariant under T......In this paper, we revisit the claim that many partition functions are invariant under reflecting temperatures to negative values (T-reflection). The goal of this paper is to demarcate which partition functions should be invariant under T-reflection, and why. Our main claim is that finite...... that T-reflection is unrelated to time-reversal. Finally, we study the interplay between T-reflection and perturbation theory in the anharmonic harmonic oscillator in quantum mechanics and in Yang-Mills in four-dimensions. This is the first in a series of papers on temperature-reflections....

Cerebral perfusion pressure, microdialysis biochemistry and clinical outcome in patients with traumatic brain injury

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Paraforou Theoniki

2011-12-01

Full Text Available Abstract Background Traumatic Brain Injury (TBI is a major cause of death and disability. It has been postulated that brain metabolic status, intracranial pressure (ICP and cerebral perfusion pressure (CPP are related to patients' outcome. The aim of this study was to investigate the relationship between CPP, ICP and microdialysis parameters and clinical outcome in TBIs. Results Thirty four individuals with severe brain injury hospitalized in an intensive care unit participated in this study. Microdialysis data were collected, along with ICP and CPP values. Glasgow Outcome Scale (GOS was used to evaluate patient outcome at 6 months after injury. Fifteen patients with a CPP greater than 75 mmHg, L/P ratio lower than 37 and Glycerol concentration lower than 72 mmol/l had an excellent outcome (GOS 4 or 5, as opposed to the remaining 19 patients. No patient with a favorable outcome had a CPP lower than 75 mmHg or Glycerol concentration and L/P ratio greater than 72 mmol/l and 37 respectively. Data regarding L/P ratio and Glycerol concentration were statistically significant at p = 0.05 when patients with favorable and unfavorable outcome were compared. In a logistic regression model adjusted for age, sex and Glasgow Coma Scale on admission, a CPP greater than 75 mmHg was marginally statistically significantly related to outcome at 6 months after injury. Conclusions Patients with favorable outcome had certain common features in terms of microdialysis parameters and CPP values. An individualized approach regarding CPP levels and cut -off points for Glycerol concentration and L/P ratio are proposed.

Optimizing outcomes with multifocal intraocular lenses

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Gitansha Shreyas Sachdev

2017-01-01

Full Text Available Modern day cataract surgery is evolving from a visual restorative to a refractive procedure. The advent of multifocal intraocular lenses (MFIOLs allows greater spectacle independence and increased quality of life postoperatively. Since the inception in 1980s, MFIOLs have undergone various technical advancements including trifocal and extended depth of vision implants more recently. A thorough preoperative workup including the patients' visual needs and inherent ocular anatomy allows us to achieve superior outcomes. This review offers a comprehensive overview of the various types of MFIOLs and principles of optimizing outcomes through a comprehensive preoperative screening and management of postoperative complications.

Reflection on the Development of a Research Agenda in Rural Health

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Lisa Bourke

2015-09-01

Full Text Available There is a dearth of literature on how research agendas have been developed. In this article, the authors reflect on the process of developing a research agenda through a case study of a rural health university centre. The aim is to contribute to understanding how a team can effectively plan research. Two leaders of the process, as well as academics external to the process, reflected on the experience and the outcome of the agenda development process. Reflections focused on three areas: (a engagement levels, (b power and influence, and (c interpretation of the research agenda. First, while there was passionate discussion at meetings and afterward, engagement levels varied. Second, the process was imbued with power and influence at multiple levels. Finally, the availability of a conceptual framework to contextualise rural and remote health research helped in interpreting the significance of the resulting research agenda. The article concludes with contrasting thoughts on the place of research agendas within contemporary neoliberal regimes of research management.

Theory of reflection reflection and transmission of electromagnetic, particle and acoustic waves

CERN Document Server

Lekner, John

2016-01-01

This book deals with the reflection of electromagnetic and particle waves by interfaces. The interfaces can be sharp or diffuse. The topics of the book contain absorption, inverse problems, anisotropy, pulses and finite beams, rough surfaces, matrix methods, numerical methods,  reflection of particle waves and neutron reflection. Exact general results are presented, followed by long wave reflection, variational theory, reflection amplitude equations of the Riccati type, and reflection of short waves. The Second Edition of the Theory of Reflection is an updated and much enlarged revision of the 1987 monograph. There are new chapters on periodically stratified media, ellipsometry, chiral media, neutron reflection and reflection of acoustic waves. The chapter on anisotropy is much extended, with a complete treatment of the reflection and transmission properties of arbitrarily oriented uniaxial crystals. The book gives a systematic and unified treatment reflection and transmission of electromagnetic and particle...

Cultivating Reflective Practitioners in Technology Preparation: Constructing TPACK through Reflection

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Liangyue Lu

2013-12-01

Full Text Available Teaching is a complex profession, which is further complicated by the integration of technology into classrooms. Reflection can help teachers unpack the complexity in their practice. Reflection can be an effective instructional strategy in helping preservice teachers develop technological pedagogical content knowledge (TPACK, the complex and dynamic knowledge necessary for effective technology integration into instruction. In this study, reflective activities were integrated into a Learning By Design (LBD environment, which was created to help preservice teachers develop TPACK. This paper investigated the participants’ TPACK development and examined how reflection helped them construct TPACK. Through content analysis of the participants’ reflective journals, the researcher found that the preservice teachers developed initial TPACK awareness. However, their reflection in technology knowledge and the content aspects of TPACK were limited and superficial. Interviews with the participants showed reflection helped the preservice teachers remember what they learned by describing and elaborating on their in-class experiences, pushed them to think about how to apply what they learned in their future classrooms, and helped them become more reflective and open-minded about using technology in classrooms. Finally, the researcher discussed this study’s implications for teacher educators and researchers.

Attending to Objects as Outcomes of Design Research

DEFF Research Database (Denmark)

Jenkins, Tom; Andersen, Kristina; Gaver, William

2016-01-01

outcomes. The premise of this workshop is simple: We need additional spaces for interacting with and reflecting upon material design outcomes at CHI. The goal of this workshop is to experiment with such a space, and to initially do so without a strong theoretical or conceptual framing.......The goal for this workshop is to provide a venue at CHI for research through design practitioners to materially share their work with each other. Conversation will largely be centered upon a discussion of objects produced through a research through design process. Bringing together researchers...

Decreasing food fussiness in children with obesity leads to greater weight loss in family-based treatment.

Science.gov (United States)

Hayes, Jacqueline F; Altman, Myra; Kolko, Rachel P; Balantekin, Katherine N; Holland, Jodi Cahill; Stein, Richard I; Saelens, Brian E; Welch, R Robinson; Perri, Michael G; Schechtman, Kenneth B; Epstein, Leonard H; Wilfley, Denise E

2016-10-01

Food fussiness (FF), or the frequent rejection of both familiar and unfamiliar foods, is common among children and, given its link to poor diet quality, may contribute to the onset and/or maintenance of childhood obesity. This study examined child FF in association with anthropometric variables and diet in children with overweight/obesity participating in family-based behavioral weight loss treatment (FBT). Change in FF was assessed in relation to FBT outcome, including whether change in diet quality mediated the relation between change in FF and change in child weight. Child (N = 170; age = 9.41 ± 1.23) height and weight were measured, and parents completed FF questionnaires and three 24-h recalls of child diet at baseline and post-treatment. Healthy Eating Index-2005 scores were calculated. At baseline, child FF was related to lower vegetable intake. Average child FF decreased from start to end of FBT. Greater decreases in FF were associated with greater reductions in child body mass index and improved overall diet quality. Overall, diet quality change through FBT mediated the relation between child FF change and child body mass index change. Children with high FF can benefit from FBT, and addressing FF may be important in childhood obesity treatment to maximize weight outcomes. © 2016 The Obesity Society.

Dietary patterns and relationship to obesity-related health outcomes and mortality in adults 75 years of age or greater

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Background: The prevalence of obesity-related adverse health outcomes is increasing among older adults. Because it is thought that nutrition plays an important role in successful aging, there has been considerable interest in the association between dietary patterns of older adults and obesity-relat...

REFLECTIVE PRACTICE IN ORGANIZATIONAL LEARNING, CULTURAL SELF-UNDERSTANDING, AND COMMUNITY SELF-STRENGTHENING.

Science.gov (United States)

Sparrow, Joshua

2016-11-01

The infant mental health field can amplify its effects when it extends its purview beyond the dyad to the larger contexts in which infants and adult caregivers interact and develop over time. Within health, mental health, education, and other human service organizations, the quality of relationships is a critical variable in the individual-level outcomes that such organizations seek. The goals of this work and the means for accomplishing them are highly dependent on human qualities and interactions that are shaped by organizational processes. In communities, too, processes that shape relationships also strongly influence child-, family-, and community-level outcomes. The Touchpoints approach to reflective practice can guide relational processes among professionals, parents, and infants in organizations and communities that influence these outcomes. © 2016 Michigan Association for Infant Mental Health.

Reflective Practice in the Clinical Setting: A Multi-Institutional Qualitative Study of Pediatric Faculty and Residents.

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Plant, Jennifer; Li, Su-Ting T; Blankenburg, Rebecca; Bogetz, Alyssa L; Long, Michele; Butani, Lavjay

2017-11-01

To explore when and in what form pediatric faculty and residents practice reflection. From February to June 2015, the authors conducted focus groups of pediatric faculty and residents at the University of California, Davis; Stanford University; and the University of California, San Francisco, until thematic saturation occurred. Transcripts were analyzed based on Mezirow's and Schon's models of reflection, using the constant comparative method associated with grounded theory. Two investigators independently coded transcripts and reconciled codes to develop themes. All investigators reviewed the codes and developed a final list of themes through consensus. Through iterative discussions, investigators developed a conceptual model of reflection in the clinical setting. Seventeen faculty and 20 residents from three institutions participated in six focus groups. Five themes emerged: triggers of reflection, intrinsic factors, extrinsic factors, timing, and outcome of reflection. Various triggers led to reflection; whether a specific trigger led to reflection depended on intrinsic and extrinsic factors. When reflection occurred, it happened in action or on action. Under optimal conditions, this reflection was goal and action directed and became critical reflection. In other instances, this process resulted in unproductive rumination or acted as an emotional release or supportive therapy. Participants reflected in clinical settings, but did not always explicitly identify it as reflection or reflect in growth-promoting ways. Strategies to enhance critical reflection include developing knowledge and skills in reflection, providing performance data to inform reflection, creating time and space for safe reflection, and providing mentorship to guide the process.

Spatiotemporal distribution and variation of GPP in the Greater Khingan Mountains from 1982 to 2015

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Hu, L.; Fan, W.; Liu, S.; Ren, H.; Xu, X.

2017-12-01

GPP (Gross Primary Productivity) is an important index to reflect the productivity of plants because it refers to the organic accumulated by green plants on land through assimilating the carbon dioxide in the atmosphere by photosynthesis and a serial of physiological processes in plants. Therefore, GPP plays a significant role in studying the carbon sink of terrestrial ecosystem and plants' reaction to global climate change. Remote sensing provides an efficient way to estimate GPP at regional and global scales and its products can be used to monitor the spatiotemporal variation of terrestrial ecosystem.As the Greater Khingan Mountains is the only bright coniferous forest of cool temperate zone in China and accounts for about 30% of the forest in China. This region is sensitive to climate change, but its forest coverage presented a significant variation due to fire disasters, excessive deforestation and so on. Here, we aimed at studying the variation pattern of GPP in the Greater Khingan Mountains and further found impact factors for the change in order to improve the understanding of what have and will happen on plants and carbon cycle under climate change.Based on GPP product from the GLASS program, we first studied spatial distribution of plants in the Greater Khingan Mountains from 1982 to 2015. With a linear regression model, seasonal and inter-annual GPP variability were explored on pixel and regional scale. We analyzed some climatic factors (e.g. temperature and precipitation) and terrain in order to find the driven factors for the GPP variations. The Growing Season Length (GSL) was also regarded as a factor and was retrieved from GIMMS 3g NDVI datasets using dynamic threshold method. We found that GPP in study area linearly decreased with the increasing elevation. Both annual accumulated GPP (AAG) and maximum daily GPP (during mid-June to mid-July) gained obvious improvement over the past 34 years under climate warming and drying (Fig.1 and Fig.2). Further

The art and science of using routine outcome measurement in mental health benchmarking.

Science.gov (United States)

McKay, Roderick; Coombs, Tim; Duerden, David

2014-02-01

To report and critique the application of routine outcome measurement data when benchmarking Australian mental health services. The experience of the authors as participants and facilitators of benchmarking activities is augmented by a review of the literature regarding mental health benchmarking in Australia. Although the published literature is limited, in practice, routine outcome measures, in particular the Health of the National Outcomes Scales (HoNOS) family of measures, are used in a variety of benchmarking activities. Use in exploring similarities and differences in consumers between services and the outcomes of care are illustrated. This requires the rigour of science in data management and interpretation, supplemented by the art that comes from clinical experience, a desire to reflect on clinical practice and the flexibility to use incomplete data to explore clinical practice. Routine outcome measurement data can be used in a variety of ways to support mental health benchmarking. With the increasing sophistication of information development in mental health, the opportunity to become involved in benchmarking will continue to increase. The techniques used during benchmarking and the insights gathered may prove useful to support reflection on practice by psychiatrists and other senior mental health clinicians.

Ultra-wideband reflective polarization converter based on anisotropic metasurface

International Nuclear Information System (INIS)

Wu Jia-Liang; Lin Bao-Qin; Da Xin-Yu

2016-01-01

In this paper, we propose an ultra-wideband reflective linear cross-polarization converter based on anisotropic metasurface. Its unit cell is composed of a square-shaped resonator with intersectant diagonal and metallic ground sheet separated by dielectric substrate. Simulated results show that the converter can generate resonances at four frequencies under normal incident electromagnetic (EM) wave, leading to the bandwidth expansion of cross-polarization reflection. For verification, the designed polarization converter is fabricated and measured. The measured and simulated results agree well with each other, showing that the fabricated converter can convert x - or y -polarized incident wave into its cross polarized wave in a frequency range from 7.57 GHz to 20.46 GHz with a relative bandwidth of 91.2%, and the polarization conversion efficiency is greater than 90%. The proposed polarization converter has a simple geometry but an ultra wideband compared with the published designs, and hence possesses potential applications in novel polarization-control devices. (paper)

Redefining Outcome Measurement: A Model for Brief Psychotherapy.

Science.gov (United States)

McGuinty, Everett; Nelson, John; Carlson, Alain; Crowther, Eric; Bednar, Dina; Foroughe, Mirisse

2016-05-01

The zeitgeist for short-term psychotherapy efficacy has fundamentally shifted away from evidence-based practices to include evidence-informed practices, resulting in an equally important paradigm shift in outcome measurement designed to reflect change in this short-term modality. The present article delineates a short-term psychotherapy structure which defines four fundamental stages that all brief therapies may have in common, and are represented through Cognitive Behavioral Therapy, Solution-Focused Brief Therapy, Narrative Therapy, and Emotion-Focused Therapy. These four theoretical approaches were analyzed via a selected literature review through comparing and contrasting specific and common tasks as they relate to the process of psychotherapy and change. Once commonalities were identified within session, they were categorized or grouped into themes or general stages of change within the parameters of a four to six session model of short-term therapy. Commonalities in therapeutic stages of change may more accurately and uniformly measure outcome in short-term work, unlike the symptom-specific psychometric instruments of longer-term psychotherapy. A systematic framework for evaluating the client and clinician adherence to 20 specific tasks for these four short-term therapies is presented through the newly proposed, Brief Task Acquisition Scale (BTAS). It is further proposed that the client-clinicians' adherence to these tasks will track and ultimately increase treatment integrity. Thus, when the client-clinician relationship tracks and evaluates the three pillars of (1) stage/process change, (2) task acquisition, and (3) treatment integrity, the culmination of these efforts presents a new way of more sensitively measuring outcome in short-term psychotherapy. Data collection is suggested as a first step to empirically evaluate the testable hypotheses suggested within this current model. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message The

The clinical-familial correlates and naturalistic outcome of panic-disorder-agoraphobia with and without lifetime bipolar II comorbidity

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Toni Cristina

2008-11-01

Full Text Available Abstract Background Much of the literature on panic disorder (PD-bipolar disorder (BP cormorbidity concerns BP-I. This literature emphasizes the difficulties encountered in pharmacologic treatment and outcome when such comorbidity is present. The present report explores these issues with respect to BP-II. Methods The sample comprised 326 outpatients (aged 34.5 ± 11.5 years old; 222 females with Diagnostic and Statistical Manual of Mental Disorders 3rd edn, revised (DSM-III-R PD-agoraphobia; among them 52 subjects (16% were affected by lifetime comorbidity with BP-II. Patients were evaluated by means of the Structured Clinical Interview for DSM-IV (SCID, the Panic-Agoraphobia Interview, and the Longitudinal Interview Follow-up Examination (Life-Up and treated according to routine clinical practice at the University of Pisa, Italy, for a period of 3 years. Clinical and course features were compared between subjects with and without BP-II. All patients received the clinicians' choice of antidepressants and, in the case of the subsample with BP-II, mood stabilizers (for example, valproate, lithium were among the mainstays of treatment. Results In comparison to patients without bipolar comorbidity, those with BP-II showed a significantly greater frequency of social phobia, obsessive-compulsive disorder, alcohol-related disorders, and separation anxiety during childhood and adolescence. Regarding family history, a significantly greater frequency of PD and mood disorders was present among the BP-II. No significant differences were observed in the long-term course of PD or agoraphobic symptoms under pharmacological treatment or the likelihood of spontaneous pharmacological treatment interruptions. Conclusion Although the severity and outcome of panic-agoraphobic symptomatology appear to be similar in patients with and without lifetime bipolar comorbidity, the higher number of concomitant disorders in our PD patients with BP-II does indicate a greater

Surgical treatment of superior oblique palsy: Predictors of outcome

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Pilar Merino Sanz

2017-01-01

Full Text Available Purpose: The purpose of this study was to evaluate the incidence and outcome of surgically treated superior oblique palsy (SOP and the factors involved in its resolution. Methods: We performed a retrospective study of 76 patients who underwent surgery for SOP. We recorded data from the physical examination and the number and type of procedures performed. Favorable outcome was defined as resolution of or improvement in torticollis (≤5° and diplopia in primary position (PP and downgaze or as vertical deviation (VD <5 prism diopters (pd in PP and 10 pd in the oblique diagnostic position. Results: Mean age was 33.12 years. Congenital SOP was the most frequent type (65.8%. Mean preoperative VD was 15.89 ± 9.94 pd, decreasing to 3.07 ± 4.36 pd after surgery. Associated horizontal deviation was recorded in 51.32% of cases. The mean number of procedures was 1.37 ± 0.62 (range 1–4, with 69.7% of patients requiring only one procedure. The mean number of muscles operated on was 1.96 ± 1.01 (inferior oblique being the most frequent. A greater reduction in VD after surgery was observed in patients with congenital SOP (P = 0.04. Although none of the factors evaluated influenced surgical outcome, amblyopic patients had a greater risk of reoperation (P = 0.04. A favorable outcome was achieved in 75% of cases. Mean follow-up was 37.08 months. Conclusion: Congenital SOP was twice as frequent as acquired SOP and although surgery was successful in most cases, a greater reduction in VD was obtained in congenital cases. Amblyopia was identified as a risk factor for reoperation.

Self-mastery among Chinese Older Adults in the Greater Chicago Area

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Xinqi Dong

2014-09-01

Full Text Available Background: Self-mastery is an important psychological resource to cope with stressful situations. However, we have limited understanding of self-mastery among minority aging populations. Objective: This study aims to examine the presence and levels of self-mastery among U.S. Chinese older adults. Methods: Data were drawn from the PINE study, a population-based survey of U.S. Chinese older adults in the Greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. A Chinese version of the Self-Mastery Scale was used to assess self-mastery. Results: Out of the 7-item Chinese Self-Mastery Scale, approximately 42.8% to 87.5% of Chinese older adults experienced some degree of self-mastery in their lives. Older adults with no formal education and the oldest-old aged 85 and over had the lowest level of self-mastery in our study. A higher mastery level was associated with being married, having fewer children, better self-reported health status, better quality of life, and positive health changes. Conclusion: Although self-mastery is commonly experienced among the Chinese aging population in the Greater Chicago area, specific subgroups are still vulnerable. Future longitudinal studies are needed to improve the understanding of risk factors and outcomes associated with self-mastery among Chinese older adults.

Glimpses into the transition world: New graduate nurses' written reflections.

Science.gov (United States)

Walton, Jo Ann; Lindsay, Natalie; Hales, Caz; Rook, Helen

2018-01-01

This study was born out of our reflections as educators responsible for helping new graduate nurses transition into their first year of professional practice through a formal education programme. Finding ourselves wondering about many of the questions the students raised with us, we set about looking more closely at what could be gleaned from the students' experience, captured in their written work over the course of a year. To identify the challenges and learning experiences revealed in reflective assignments written by new graduate nurses undertaking a postgraduate course as part of their transition to registered nurse practice. Data consisted of the written work of two cohorts of students who had completed a postgraduate university course as part of their transition to new graduate practice in New Zealand. Fifty four reflective essays completed by twenty seven participating students were collected and their contents analysed thematically. Five key themes were identified. The students' reflections noted individual attributes - personal and professional strengths and weaknesses; professional behaviour - actions such as engaging help and support, advocating for patients' needs and safety and putting their own feelings aside; situational challenges such as communication difficulties, both systemic and interpersonal, and the pressure of competing demands. Students also identified rewards - results they experienced such as achieving the nursing outcomes they desired, and commented on reflection as a useful tool. The findings shed light on the experiences of new graduates, and how they fare through this critical phase of career development. Challenges relating to the emotional labour of nursing work are particularly evident. In addition the reflective essay is shown to be a powerful tool for assisting both new graduate nurses and their lecturers to reflect on the learning opportunities inherent in current clinical practice environments. Copyright © 2017 Elsevier Ltd

Pondering practice: Enhancing the art of reflection.

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Hayes, Carolyn; Jackson, Debra; Davidson, Patricia M; Daly, John; Power, Tamara

2018-01-01

The aim of this study was to describe the effect that immersive simulation experiences and guided reflection can have on the undergraduate nurses' understanding of how stressful environments impact their emotions, performance and ability to implement safe administration of medications. Patient safety can be jeopardised if nurses are unsure of how to appropriately manage and respond to interruptions. Medication administration errors are a major patient safety issue and often occur as a consequence of ineffective interruption management. The skills associated with medication administration are most often taught to, and performed by, undergraduate nurses in a controlled environment. However, the clinical environment in which nurses are expected to administer medications is often highly stressed and nurses are frequently interrupted. This study used role-play simulation and written reflections to facilitate deeper levels of student self-awareness. A qualitative approach was taken to explore students' understanding of the effects of interruptions on their ability to undertake safe medication administration. Convenience sampling of second-year undergraduate nursing students enrolled in a medical-surgical subject was used in this study. Data were obtained from 451:528 (85.42%) of those students and analysed using thematic analysis. Students reported increasing consciousness and the importance of reflection for evaluating performance and gaining self-awareness. They described self-awareness, effective communication, compassion and empathy as significant factors in facilitating self-efficacy and improved patient care outcomes. Following a role-play simulation experience, student nurses reported new knowledge and skill acquisition related to patient safety, and new awareness of the need for empathetic and compassionate care during medication administration. Practicing medication administration in realistic settings adds to current strategies that aim to reduce medication

[Clinical Results of Endoscopic Treatment of Greater Trochanteric Pain Syndrome].

Science.gov (United States)

Zeman, P; Rafi, M; Skala, P; Zeman, J; Matějka, J; Pavelka, T

2017-01-01

PURPOSE OF THE STUDY This retrospective study aims to present short-term clinical outcomes of endoscopic treatment of patients with greater trochanteric pain syndrome (GTPS). MATERIAL AND METHODS The evaluated study population was composed of a total of 19 patients (16 women, 3 men) with the mean age of 47 years (19-63 years). In twelve cases the right hip joint was affected, in the remaining seven cases it was the left side. The retrospective evaluation was carried out only in patients with greater trochanteric pain syndrome caused by independent chronic trochanteric bursitis without the presence of m. gluteus medius tear not responding to at least 3 months of conservative treatment. In patients from the followed-up study population, endoscopic trochanteric bursectomy was performed alone or in combination with iliotibial band release. The clinical results were evaluated preoperatively and with a minimum follow-up period of 1 year after the surgery (mean 16 months). The Visual Analogue Scale (VAS) for assessment of pain and WOMAC (Western Ontario MacMaster) score were used. In both the evaluated criteria (VAS and WOMAC score) preoperative and postoperative results were compared. Moreover, duration of surgery and presence of postoperative complications were assessed. Statistical evaluation of clinical results was carried out by an independent statistician. In order to compare the parameter of WOMAC score and VAS pre- and post-operatively the Mann-Whitney Exact Test was used. The statistical significance was set at 0.05. RESULTS The preoperative VAS score ranged 5-9 (mean 7.6) and the postoperative VAS ranged 0-5 (mean 2.3). The WOMAC score ranged 56.3-69.7 (mean 64.2) preoperatively and 79.8-98.3 (mean 89.7) postoperatively. When both the evaluated parameters of VAS and WOMAC score were compared in time, a statistically significant improvement (ppain syndrome yields statistically significant improvement of clinical results with the concurrent minimum incidence of

Coping Skills Help Explain How Future-Oriented Adolescents Accrue Greater Well-Being Over Time.

Science.gov (United States)

Chua, Li Wen; Milfont, Taciano L; Jose, Paul E

2015-11-01

Adolescents who endorse greater levels of future orientation report greater well-being over time, but we do not know the mechanism by which this happens. The present longitudinal study examined whether both adaptive as well as maladaptive coping strategies might explain how future orientation leads to ill-being and well-being over time in young New Zealanders. A sample of 1,774 preadolescents and early adolescents (51.9 % female) aged 10-15 years at Time 1 completed a self-report survey three times with 1 year intervals in between. Longitudinal mediation path models were constructed to determine whether and how maladaptive and adaptive coping strategies at Time 2 functioned as mediators between future orientation at Time 1 and ill-being and well-being at Time 3. Results showed that future orientation predicted lower maladaptive coping, which in turn predicted lower substance use and self-harming behavior. All three well-being outcomes (i.e., happiness with weight, vitality, and sleep) were consistently predicted by future orientation, and all three pathways were mediated by both lower maladaptive and higher adaptive coping strategies (with the exception of happiness with weight, which was mediated only by lower maladaptive coping). The results suggest that several pathways by which future orientation leads to greater well-being occurs through an increased use of adaptive coping, a decreased use of maladaptive coping, or both.

Issues in reflection and debriefing: how nurse educators structure experiential activities.

Science.gov (United States)

Brackenreg, Jenni

2004-12-01

Experiential learning is particularly useful in vocational education programs where theory needs to be linked to practice. Although experiential learning is often advocated in nursing education and the importance of debriefing and reflection is almost always espoused, the focus in the literature has tended to be on detailed descriptions of the action phase with little close analysis of how the reflective phase is facilitated. The Lewinian model described by Kolb [Experiential Learning. Experience as Source of Learning and Development, Prentice-Hall, New Jersey, 1984] and the structuring approach suggested by Thiagarajan [Experiential Learning Packages, Prentice-Hall, Englewood Cliffs, NJ, 1980] have been used as the theoretical context for an exploration of how nurse teachers describe their facilitation of the debriefing and reflective phases of experiential learning activities. Explication of the entire planned experiential learning experience is important for increasing the chances of the student being able to close the experiential learning loop. The more covert reflective phases for facilitating experiential learning are crucial and if neglected, or inexpertly and insensitively handled, may at best lead to poor learning outcomes or at worst lead to emotional damage and ;unfinished business' for the student. Interviews with eight experienced university educators elicited descriptions of how they constructed experiential activities with special reference to their descriptions of how the debriefing or reflective phases were structured.

Evaluating Leaf and Canopy Reflectance of Stressed Rice Plants to Monitor Arsenic Contamination

Directory of Open Access Journals (Sweden)

Varaprasad Bandaru

2016-06-01

Full Text Available Arsenic contamination is a serious problem in rice cultivated soils of many developing countries. Hence, it is critical to monitor and control arsenic uptake in rice plants to avoid adverse effects on human health. This study evaluated the feasibility of using reflectance spectroscopy to monitor arsenic in rice plants. Four arsenic levels were induced in hydroponically grown rice plants with application of 0, 5, 10 and 20 µmol·L−1 sodium arsenate. Reflectance spectra of upper fully expanded leaves were acquired over visible and infrared (NIR wavelengths. Additionally, canopy reflectance for the four arsenic levels was simulated using SAIL (Scattering by Arbitrarily Inclined Leaves model for various soil moisture conditions and leaf area indices (LAI. Further, sensitivity of various vegetative indices (VIs to arsenic levels was assessed. Results suggest that plants accumulate high arsenic amounts causing plant stress and changes in reflectance characteristics. All leaf spectra based VIs related strongly with arsenic with coefficient of determination (r2 greater than 0.6 while at canopy scale, background reflectance and LAI confounded with spectral signals of arsenic affecting the VIs’ performance. Among studied VIs, combined index, transformed chlorophyll absorption reflectance index (TCARI/optimized soil adjusted vegetation index (OSAVI exhibited higher sensitivity to arsenic levels and better resistance to soil backgrounds and LAI followed by red edge based VIs (modified chlorophyll absorption reflectance index (MCARI and TCARI suggesting that these VIs could prove to be valuable aids for monitoring arsenic in rice fields.

The Influence of Green Infrastructure on Urban Resilience in Greater London

Science.gov (United States)

Oh, Yukyung

2017-04-01

, worthwhileness, happiness and anxiety. The correlation analysis outcomes can be divided into three levels such as Greater London as a whole, and Inner and Outer London. In Greater London, total area of green spaces has a strong relation with crime rates, and a less strong relation with number of jobs. Both socioeconomic indicators showed a negative trend along with the increase of open spaces. In terms of wellbeing indicators, the positive trend of life satisfaction, worthwhileness and happiness, and the negative trend of anxiety can be found in accordance with the increase of green coverage. In Inner London, job density and crime rates show a negative trend in accordance with the increase of total open space areas. And as contagion of open spaces is higher, the indicators of number of jobs, jobs density, and crime rates also showed an increase tendency. As for worthwhileness and happiness, it also showed a substantial correlation with contagion of open spaces. In Outer London, the correlation between job density and crime rates, and open space cannot be found, but the wellbeing indicators such as life satisfaction and worthwhileness show an increase trend along with larger green coverage.

The integration of blended learning into an occupational therapy curriculum: a qualitative reflection.

Science.gov (United States)

Barnard-Ashton, Paula; Rothberg, Alan; McInerney, Patricia

2017-08-17

This paper presents a critical reflection of the integration of Blended Learning (BL) into an undergraduate occupational therapy curriculum which was delivered through Problem Based Learning (PBL). This is a qualitative reflection of a Participatory Action Research (PAR) study using Brookfield's model for critical reflection of an educator's practice. The model uses four 'lenses' through which to focus enquiry: Lens 1) our autobiography as a learner of practice; Lens 2) our learners' eyes; Lens 3) our colleagues' experiences; and Lens 4) the theoretical literature. Grounded theory analysis was applied to the data. The factors that contributed to successful integration of technology and e-Learning into an existing curriculum, the hurdles that were navigated along the way, and how these influenced decisions and innovation are explored. The core categories identified in the data were "drivers of change" and "outcomes of BL integration". Key situations and pivotal events are highlighted for their role in the process that led to the project maturing. Each lens reflects the successes and hurdles experienced during the study. Brookfield's model provides an objective method of reflection which showed that despite the hurdles, e-Learning was successfully integrated into the curriculum.

The Co-mentoring Project: Overview and Outcomes

Directory of Open Access Journals (Sweden)

Renée A. Zucchero, PhD

2008-08-01

Full Text Available The Co-mentoring Project matched developmental psychology students with older adult volunteers for an intergenerational learning experience. Students conducted a biopsychosocial life review to increase understanding of older adult development and the continuity in lifespan development. Each student developed a summary paper containing the older adult’s life history, a developmental analysis, and personal reflection. A project description, including the scholarship of teaching and learning, and an overview of its outcomes are presented. The project goal was accomplished; students positively evaluated learning outcomes and displayed a significant increase in knowledge about older adults and aging. Implications for college instructors are discussed.

PARANOID INDIVIDUALS WITH SCHIZOPHRENIA SHOW GREATER SOCIAL COGNITIVE BIAS AND WORSE SOCIAL FUNCTIONING THAN NON-PARANOID INDIVIDUALS WITH SCHIZOPHRENIA.

Science.gov (United States)

Pinkham, Amy E; Harvey, Philip D; Penn, David L

2016-03-01

Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid individuals with schizophrenia differ in social cognition and functional outcomes. On measures assessing social cognitive bias, paranoid individuals endorsed more hostile and blaming attributions and identified more faces as untrustworthy; however, paranoid and non-paranoid individuals did not differ on emotion recognition and theory of mind tasks assessing social cognitive ability. Likewise, paranoid individuals showed greater impairments in real-world interpersonal relationships and social acceptability as compared to non-paranoid patients, but these differences did not extend to performance based tasks assessing functional capacity and social competence. These findings isolate specific social cognitive disparities between paranoid and non-paranoid subgroups and suggest that paranoia may exacerbate the social dysfunction that is commonly experienced by individuals with schizophrenia.

Greater autonomy at work

NARCIS (Netherlands)

Houtman, I.L.D.

2004-01-01

In the past 10 years, workers in the Netherlands increasingly report more decision-making power in their work. This is important for an economy in recession and where workers face greater work demands. It makes work more interesting, creates a healthier work environment, and provides opportunities

Modeling the economic outcomes of immuno-oncology drugs: alternative model frameworks to capture clinical outcomes.

Science.gov (United States)

Gibson, E J; Begum, N; Koblbauer, I; Dranitsaris, G; Liew, D; McEwan, P; Tahami Monfared, A A; Yuan, Y; Juarez-Garcia, A; Tyas, D; Lees, M

2018-01-01

Economic models in oncology are commonly based on the three-state partitioned survival model (PSM) distinguishing between progression-free and progressive states. However, the heterogeneity of responses observed in immuno-oncology (I-O) suggests that new approaches may be appropriate to reflect disease dynamics meaningfully. This study explored the impact of incorporating immune-specific health states into economic models of I-O therapy. Two variants of the PSM and a Markov model were populated with data from one clinical trial in metastatic melanoma patients. Short-term modeled outcomes were benchmarked to the clinical trial data and a lifetime model horizon provided estimates of life years and quality adjusted life years (QALYs). The PSM-based models produced short-term outcomes closely matching the trial outcomes. Adding health states generated increased QALYs while providing a more granular representation of outcomes for decision making. The Markov model gave the greatest level of detail on outcomes but gave short-term results which diverged from those of the trial (overstating year 1 progression-free survival by around 60%). Increased sophistication in the representation of disease dynamics in economic models is desirable when attempting to model treatment response in I-O. However, the assumptions underlying different model structures and the availability of data for health state mapping may be important limiting factors.

Peer group reflection helps clinical teachers to critically reflect on their teaching.

Science.gov (United States)

Boerboom, Tobias B B; Jaarsma, Debbie; Dolmans, Diana H J M; Scherpbier, Albert J J A; Mastenbroek, Nicole J J M; Van Beukelen, Peter

2011-01-01

Student evaluations can help clinical teachers to reflect on their teaching skills and find ways to improve their teaching. Studies have shown that the mere presentation of student evaluations is not a sufficient incentive for teachers to critically reflect on their teaching. We evaluated and compared the effectiveness of two feedback facilitation strategies that were identical except for a peer reflection meeting. In this study, 54 clinical teachers were randomly assigned to two feedback strategies. In one strategy, a peer reflection was added as an additional step. All teachers completed a questionnaire evaluating the strategy that they had experienced. We analysed the reflection reports and the evaluation questionnaire. Both strategies stimulated teachers to reflect on feedback and formulate alternative actions for their teaching practice. The teachers who had participated in the peer reflection meeting showed deeper critical reflection and more concrete plans to change their teaching. All feedback strategies were considered effective by the majority of the teachers. Strategies with student feedback and self-assessment stimulated reflection on teaching and helped clinical teachers to formulate plans for improvement. A peer reflection meeting seemed to enhance reflection quality. Further research should establish whether it can have lasting effects on teaching quality.

Hypermetabolism in ALS is associated with greater functional decline and shorter survival.

Science.gov (United States)

Steyn, Frederik J; Ioannides, Zara A; van Eijk, Ruben P A; Heggie, Susan; Thorpe, Kathryn A; Ceslis, Amelia; Heshmat, Saman; Henders, Anjali K; Wray, Naomi R; van den Berg, Leonard H; Henderson, Robert D; McCombe, Pamela A; Ngo, Shyuan T

2018-04-29

To determine the prevalence of hypermetabolism, relative to body composition, in amyotrophic lateral sclerosis (ALS) and its relationship with clinical features of disease and survival. Fifty-eight patients with clinically definite or probable ALS as defined by El Escorial criteria, and 58 age and sex-matched control participants underwent assessment of energy expenditure. Our primary outcome was the prevalence of hypermetabolism in cases and controls. Longitudinal changes in clinical parameters between hypermetabolic and normometabolic patients with ALS were determined for up to 12 months following metabolic assessment. Survival was monitored over a 30-month period following metabolic assessment. Hypermetabolism was more prevalent in patients with ALS than controls (41% vs 12%, adjusted OR=5.4; pALS. Mean lower motor neuron score (SD) was greater in hypermetabolic patients when compared with normometabolic patients (4 (0.3) vs 3 (0.7); p=0.04). In the 12 months following metabolic assessment, there was a greater change in Revised ALS Functional Rating Scale score in hypermetabolic patients when compared with normometabolic patients (-0.68 points/month vs -0.39 points/month; p=0.01). Hypermetabolism was inversely associated with survival. Overall, hypermetabolism increased the risk of death during follow-up to 220% (HR 3.2, 95% CI 1.1 to 9.4, p=0.03). Hypermetabolic patients with ALS have a greater level of lower motor neuron involvement, faster rate of functional decline and shorter survival. The metabolic index could be important for informing prognosis in ALS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Media for Reflection

DEFF Research Database (Denmark)

Knudsen, Morten

2016-01-01

This article develops the concept media for reflection in the interest of conceptualizing the interpretative frames that enable and limit reflection in management and leadership education. The concept ‘media for reflection’ allows us to conceptualize the social and cultural mediation of reflection...... without reducing reflection to an effect of the social structures and cultural norms in which it is embedded. Based on the developed theoretical framework, this article analyses how a renaissance ‘mirror for princes’ and contemporary research-based management education mediate reflection. The content...... of the mediations is analysed as well as the societal and organizational background. Furthermore, the means by which the two media enable and limit reflection in different ways is compared. Finally, the article discusses possible implications of the analysis in terms of management and leadership education....

Negative decision outcomes are more common among people with lower decision-making competence: An item-level analysis of the Decision Outcome Inventory (DOI

Directory of Open Access Journals (Sweden)

Andrew M Parker

2015-04-01

Full Text Available Most behavioral decision research takes place in carefully controlled laboratory settings, and examination of relationships between performance and specific real-world decision outcomes is rare. One prior study shows that people who perform better on hypothetical decision tasks, assessed using the Adult Decision-Making Competence (A-DMC measure, also tend to experience better real-world decision outcomes, as reported on the Decision Outcomes Inventory (DOI. The DOI score reflects avoidance of outcomes that could result from poor decisions, ranging from serious (e.g., bankruptcy to minor (e.g., blisters from sunburn. The present analyses go beyond the initial work, which focused on the overall DOI score, by analyzing the relationships between specific decision outcomes and A-DMC performance. Most outcomes are significantly more likely among people with lower A-DMC scores, even after taking into account two variables expected to produce worse real-world decision outcomes: younger age and lower socio-economic status. We discuss the usefulness of DOI as a measure of successful real-world decision making.

Patient Centered Outcomes Assessment of Retreatment and Endodontic Microsurgery Using CBCT Volumetric Analysis

Science.gov (United States)

2018-11-09

treatment outcomes assessment was conducted based upon clinical and CBCT (instead ofPA) findings. The 59th Medical Wing Institutional Review Board...IfCBCT PARL volume rendering gains prominence, greater clarity in our terminology will be possible with quantification of outcomes criteria. Each...outcomes designation could then be tied to prudent course( s) of action, which is the ultimate utility of diagnostic terminology . Clarity of terminology

The contribution of audio recording using portable digital voice recorders to the development of reflective practice with trainee teachers in a Further Education setting

Directory of Open Access Journals (Sweden)

Knill, Marta

2011-06-01

Full Text Available Developing reflective skills and habits during initial teacher education and progressing to deeper and more critical reflection are challenges for trainee teachers. This small-scale action research study investigates how two structured tasks using Digital Voice Recorders (DVRs initiated, sustained and improved reflection and reflective practice. Trainee teachers reported benefits in increased understanding of reflection, development of reflective skills, deepening of reflection and improvements in practice through joint reflection with Teacher Educators on specific aspects of teaching and learning. The structuring of the tasks with prompts and dialogue clearly contributed to the positive outcomes. The study suggests that use of the small, convenient and relatively low cost DVR technology has a place in learning to reflect.

Relationships between brain and body temperature, clinical and imaging outcomes after ischemic stroke

Science.gov (United States)

Karaszewski, Bartosz; Carpenter, Trevor K; Thomas, Ralph G R; Armitage, Paul A; Lymer, Georgina Katherine S; Marshall, Ian; Dennis, Martin S; Wardlaw, Joanna M

2013-01-01

Pyrexia soon after stroke is associated with severe stroke and poor functional outcome. Few studies have assessed brain temperature after stroke in patients, so little is known of its associations with body temperature, stroke severity, or outcome. We measured temperatures in ischemic and normal-appearing brain using 1H-magnetic resonance spectroscopy and its correlations with body (tympanic) temperature measured four-hourly, infarct growth by 5 days, early neurologic (National Institute of Health Stroke Scale, NIHSS) and late functional outcome (death or dependency). Among 40 patients (mean age 73 years, median NIHSS 7, imaged at median 17 hours), temperature in ischemic brain was higher than in normal-appearing brain on admission (38.6°C-core, 37.9°C-contralateral hemisphere, P=0.03) but both were equally elevated by 5 days; both were higher than tympanic temperature. Ischemic lesion temperature was not associated with NIHSS or 3-month functional outcome; in contrast, higher contralateral normal-appearing brain temperature was associated with worse NIHSS, infarct expansion and poor functional outcome, similar to associations for tympanic temperature. We conclude that brain temperature is higher than body temperature; that elevated temperature in ischemic brain reflects a local tissue response to ischemia, whereas pyrexia reflects the systemic response to stroke, occurs later, and is associated with adverse outcomes. PMID:23571281

Building an urban 'renaissance': fragmented services and the production of inequality in Greater Downtown Detroit.

Science.gov (United States)

Doucet, Brian; Smit, Edske

2016-01-01

Downtown Detroit has been undergoing a renaissance in recent years which is in stark contrast to the economic and social situation in much of the rest of the city. This renaissance has been taking place despite the city's ability to provide good municipal services such as streetlights, security, public space and transport. This article focuses on how four areas which constitute part of Greater Downtown Detroit have relied on different combinations of actors to create and provide the services and amenities deemed necessary for capital investment and middle-class consumption. Each area has its own initiatives and actors who implement them, further fragmenting the city between its core and periphery. Renewed public spaces, private police forces and resident initiatives in middle-class neighborhoods have been created to serve specific needs of the small areas they serve. Rather than being unique, Detroit is an extreme example of fragmented and polarized urbanism which is part and parcel of contemporary cities. We argue that rather than passively reflecting existing socio-spatial divides, these private initiatives in Greater Downtown Detroit actively contribute to the production of sociospatial inequalities across the city.

Multigenerational Challenges: Team-Building for Positive Clinical Workforce Outcomes

Science.gov (United States)

Moore, Jill M; Everly, Marcee; Bauer, Renee

2016-05-31

Patient acuity in hospital settings continues to increase, and there is greater emphasis on patient outcomes. The current nursing workforce is comprised of four distinct generational cohorts that include veterans, baby boomers, millennials, and generation Xers. Each group has unique characteristics that add complexity to the workforce and this can add challenges to providing optimal patient care. Team building is one strategy to increase mutual understanding, communication, and respect, and thus potentially improve patient outcomes. In this article, we first briefly define generational cohorts by characteristics, and discuss differing expectations for work/life balance and potential negative outcomes. Our discussion offers team building strategies for positive outcomes, a case scenario, and concludes with resources for team building and organizational opportunities.

Use of reflectance spectrophotometry to predict the response of port wine stains to pulsed dye laser.

Science.gov (United States)

Halachmi, Shlomit; Azaria, Ron; Inbar, Roy; Ad-El, Dean; Lapidoth, Moshe

2014-01-01

Reflectance spectroscopy can be used to quantitate subtle differences in color. We applied a portable reflectance spectrometer to determine its utility in the evaluation of pulsed dye laser treatment of port wine stains (PWS) and in prediction of clinical outcome, in a prospective study. Forty-eight patients with PWS underwent one to nine pulsed dye laser treatments. Patient age and skin color as well as PWS surface area, anatomic location, and color were recorded. Pretreatment spectrophotometric measurements were performed. The subjective clinical results of treatment and the quantitative spectrophotometry results were evaluated by two independent teams, and the findings were correlated. The impact of the clinical characteristics on the response to treatment was assessed as well. Patients with excellent to good clinical results of laser treatments had pretreatment spectrophotometric measurements which differed by more than 10%, whereas patients with fair to poor results had spectrophotometric measurements with a difference of of less than 10%. The correlation between the spectrophotometric results and the clinical outcome was 73% (p Spectrophotometry has a higher correlation with clinical outcome and a better predictive value than other nonmeasurable, nonquantitative, dependent variables.

Fetal omphalocele ratios predict outcomes in prenatally diagnosed omphalocele.

Science.gov (United States)

Montero, Freddy J; Simpson, Lynn L; Brady, Paula C; Miller, Russell S

2011-09-01

The objective of the study was to evaluate whether ratios considering omphalocele diameter relative to fetal biometric measurements perform better than giant omphalocele designation at predicting inability to achieve neonatal primary surgical closure. Cases of fetal omphalocele that underwent evaluation between May 2003 and July 2010 were identified. Inclusion was restricted to live births with plan for postnatal repair. Omphalocele diameter upon antenatal ultrasound was compared with abdominal circumference, femur length, and head circumference, yielding the respective omphalocele (O)/abdominal circumference (AC), O/femur length (FL), and O/head circumference (HC) ratios. The absolute measurements were used to classify giant lesions. Omphalocele ratios and giant omphalocele designations were evaluated as predictors of inability to achieve primary repair. Among 25 included cases, staged or delayed closure occurred in 52%. With an optimal cutoff of 0.21 or greater, O/HC best predicted the primary outcome (sensitivity, 84.6%; specificity, 58.3%; odds ratio, 7.7). The O/HC of 0.21 or greater outperformed giant designations. The O/HC of 0.21 or greater best predicted staged or delayed omphalocele closure. Giant omphalocele designation, regardless of definition, poorly predicted outcome. Copyright © 2011 Mosby, Inc. All rights reserved.

5-HTTLPR polymorphism modulates neural mechanisms of negative self-reflection.

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Ma, Yina; Li, Bingfeng; Wang, Chenbo; Shi, Zhenhao; Sun, Yun; Sheng, Feng; Zhang, Yifan; Zhang, Wenxia; Rao, Yi; Han, Shihui

2014-09-01

Cognitive distortion in depression is characterized by enhanced negative thoughts about both environment and oneself. Carriers of a risk allele for depression, that is, the short (s) allele of the serotonin transporter promoter polymorphism (5-HTTLPR), exhibit amygdala hyperresponsiveness to negative environmental stimuli relative to homozygous long variant (l/l). However, the neural correlates of negative self-schema in s allele carriers remain unknown. Using functional MRI, we scanned individuals with s/s or l/l genotype of the 5-HTTLPR during reflection on their own personality traits or a friend's personality traits. We found that relative to l/l carriers, s/s carriers showed stronger distressed feelings and greater activity in the dorsal anterior cingulate (dACC)/dorsal medial prefrontal cortex (dmPFC) and the right anterior insula (AI) during negative self-reflection. The 5-HTTLPR effect on the distressed feelings was mediated by the AI/inferior frontal (IF) activity during negative self-reflection. The dACC/dmPFC activity explained 20% of the variation in harm-avoidance tendency in s/s but not l/l carriers. The genotype effects on distress and brain activity were not observed during reflection on a friend's negative traits. Our findings reveal that 5-HTTLPR polymorphism modulates distressed feelings and brain activities associated with negative self-schema and suggest a potential neurogenetic susceptibility mechanism for depression. © The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Challenged by cognition : toward optimal measurement and greater understanding of youth cognition in school refusal and cognitive behavioural therapy outcome

NARCIS (Netherlands)

Maric, Marija

2010-01-01

The main purpose of this dissertation was to highlight and address seven challenges related to the measurement of youth cognition, understanding the role of cognitive constructs in anxiety and school refusal, and the examination of cognitive mediators of cognitive-behavioural treatment outcomes. The

Maintained intentional weight loss reduces cardiovascular outcomes

DEFF Research Database (Denmark)

Caterson, I D; Finer, N; Coutinho, W

2012-01-01

Aim: The Sibutramine Cardiovascular OUTcomes trial showed that sibutramine produced greater mean weight loss than placebo but increased cardiovascular morbidity but not mortality. The relationship between 12-month weight loss and subsequent cardiovascular outcomes is explored. Methods: Overweight....../obese subjects (N = 10 744), =55 years with cardiovascular disease and/or type 2 diabetes mellitus, received sibutramine plus weight management during a 6-week Lead-in Period before randomization to continue sibutramine (N = 4906) or to receive placebo (N = 4898). The primary endpoint was the time from...... randomization to first occurrence of a primary outcome event (non-fatal myocardial infarction, non-fatal stroke, resuscitated cardiac arrest or cardiovascular death). Results: For the total population, mean weight change during Lead-in Period (sibutramine) was -2.54 kg. Post-randomization, mean total weight...

Effects of a work-based critical reflection program for novice nurses.

Science.gov (United States)

Kim, Yeon Hee; Min, Ja; Kim, Soon Hee; Shin, Sujin

2018-02-27

Critical reflection is effective in improving students' communication abilities and confidence. The aim of this study was to evaluate the effectiveness of a work-based critical reflection program to enhance novice nurses' clinical critical-thinking abilities, communication competency, and job performance. The present study used a quasi-experimental design. From October 2014 to August 2015, we collected data from 44 novice nurses working in an advanced general hospital in S city in Korea. Nurses in the experimental group participated in a critical reflection program for six months. Outcome variables were clinical critical-thinking skills, communication abilities, and job performance. A non-parametric Mann-Whitney U-test and a Wilcoxon rank sum test were selected to evaluate differences in mean ranks and to assess the null hypothesis that the medians were equal across the groups. The results showed that the clinical critical-thinking skills of those in the experimental group improved significantly (p = 0.003). The differences in mean ranks of communication ability between two groups was significantly statistically different (p = 0.028). Job performance improved significantly in both the experimental group and the control group, so there was no statistical difference (p = 0.294). We therefore suggest that a critical reflection program be considered an essential tool for improving critical thinking and communication abilities among novice nurses who need to adapt to the clinical environment as quickly as possible. Further, we suggest conducting research into critical reflection programs among larger and more diverse samples.

Mapping to Estimate Health-State Utility from Non-Preference-Based Outcome Measures: An ISPOR Good Practices for Outcomes Research Task Force Report.

Science.gov (United States)

Wailoo, Allan J; Hernandez-Alava, Monica; Manca, Andrea; Mejia, Aurelio; Ray, Joshua; Crawford, Bruce; Botteman, Marc; Busschbach, Jan

2017-01-01

Economic evaluation conducted in terms of cost per quality-adjusted life-year (QALY) provides information that decision makers find useful in many parts of the world. Ideally, clinical studies designed to assess the effectiveness of health technologies would include outcome measures that are directly linked to health utility to calculate QALYs. Often this does not happen, and even when it does, clinical studies may be insufficient for a cost-utility assessment. Mapping can solve this problem. It uses an additional data set to estimate the relationship between outcomes measured in clinical studies and health utility. This bridges the evidence gap between available evidence on the effect of a health technology in one metric and the requirement for decision makers to express it in a different one (QALYs). In 2014, ISPOR established a Good Practices for Outcome Research Task Force for mapping studies. This task force report provides recommendations to analysts undertaking mapping studies, those that use the results in cost-utility analysis, and those that need to critically review such studies. The recommendations cover all areas of mapping practice: the selection of data sets for the mapping estimation, model selection and performance assessment, reporting standards, and the use of results including the appropriate reflection of variability and uncertainty. This report is unique because it takes an international perspective, is comprehensive in its coverage of the aspects of mapping practice, and reflects the current state of the art. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Reflection groups

International Nuclear Information System (INIS)

Eggermont, G.

2006-01-01

In 2005, PISA organised proactive meetings of reflection groups on involvement in decision making, expert culture and ethical aspects of radiation protection.All reflection group meetings address particular targeted audiences while the output publication in book form is put forward

Documenting Student Engagement Using an Intention/Reflection Exercise during an Advanced Pharmacy Practice Experience

Science.gov (United States)

Fierke, Kerry K.; Lepp, Gardner A.

2015-01-01

The article shares the outcomes of a practice called Intention/Reflection (I/R) when applied to a group of ten students in a five-week course involving an international advanced pharmacy practice experience. Developed by the authors and founded on a combination of theoretical principles, this practice is unique because of the blend of formative…

The Importance of Government Effectiveness for Transitions toward Greater Electrification in Developing Countries

Directory of Open Access Journals (Sweden)

Rohan Best

2017-08-01

Full Text Available Electricity is a vital factor underlying modern living standards, but there are many developing countries with low levels of electricity access and use. We seek to systematically identify the crucial elements underlying transitions toward greater electrification in developing countries. We use a cross-sectional regression approach with national-level data up to 2012 for 135 low- and middle-income countries. The paper finds that the effectiveness of governments is the most important governance attribute for encouraging the transition to increased electrification in developing countries, on average. The results add to the growing evidence on the importance of governance for development outcomes. Donors seeking to make more successful contributions to electrification may wish to target countries with more effective governments.

Mediated and Moderated Effects of Neurocognitive Impairment on Outcomes of Treatment for Substance Dependence and Major Depression

Science.gov (United States)

Worley, Matthew J.; Tate, Susan R.; Granholm, Eric; Brown, Sandra A.

2015-01-01

Objective Neurocognitive impairment has not consistently predicted substance use treatment outcomes but has been linked to proximal mediators of outcome. These indirect effects have not been examined in adults with substance dependence and co-occurring psychiatric disorders. We examined mediators and moderators of the effects of neurocognitive impairment on substance use among adults in treatment for alcohol or drug dependence and major depression (MDD). Method Participants were veterans (N =197, mean age = 49.3 years, 90% male, 75% Caucasian) in a trial of two group interventions for alcohol/drug dependence and MDD. Measures examined here included intake neurocognitive assessments and percent days drinking (PDD), percent days using drugs (PDDRG), self-efficacy, 12-step affiliation, and depressive symptoms measured every 3 months from intake to the 18-month follow-up. Results Greater intake neurocognitive impairment predicted lower self-efficacy, lower 12-step affiliation, and greater depression severity, and these time-varying variables mediated the effects of impairment on future PDD and PDDRG. The prospective effects of 12-step affiliation on future PDD were greater for those with greater neurocognitive impairment. Impairment also interacted with depression to moderate the effects of 12-step affiliation and self-efficacy on PDD. Adults with greater impairment and currently severe depression had the strongest associations between 12-step affiliation/self-efficacy and future drinking. Conclusions Greater neurocognitive impairment may lead to poorer outcomes from group therapy for alcohol/drug dependence and MDD due to compromised change in therapeutic processes. Distal factors such as neurocognitive impairment can interact with dynamic risk factors to modulate the association between therapeutic processes and future drinking outcomes. PMID:24588403

Changes of levels of plasma ET-1 and NO after intravenous photocoagulation of the varicosis of greater saphenous vein

International Nuclear Information System (INIS)

Han Li'na; Gu Ying; Liu Fanguang

2004-01-01

Objective: To determine the changes of levels of plasma endothelin-1 (ET-1) and nitric oxide (NO) after intravenous photocoagulation of the varicosis of the greater saphenous vein. Methods: Fifty-eight patients with varicosis of greater saphenous vein were treated with intravenous photocoagulation. The levels of plasma ET-1 and NO were determined with radioimmunoassay and Griss method respectively on the 1st, 3rd, 7th and 14th day after the treatment. Another fifty-six patients with varicosis of greater saphenous vein were treated with the traditional high ligation and stripping method. The levels of ET-1 and NO on 1st, 3rd, 7th and 14th day postoperatively were also determined too. Results: The levels of ET-1 and NO, whether inphotocoagulation or traditional treatment group, increased at first, then decreased, approaching normal level finally. The peak levels of ET-1 and NO in photocoagulation group were lower than those in traditional method groups, reaching normal levels earlier. Conclusion: The levels of ET-1 and NO after treatment can reflect the intensity of stress and condition of recovery. (authors)

Experimental analysis of bidirectional reflectance distribution function cross section conversion term in direction cosine space.

Science.gov (United States)

Butler, Samuel D; Nauyoks, Stephen E; Marciniak, Michael A

2015-06-01

Of the many classes of bidirectional reflectance distribution function (BRDF) models, two popular classes of models are the microfacet model and the linear systems diffraction model. The microfacet model has the benefit of speed and simplicity, as it uses geometric optics approximations, while linear systems theory uses a diffraction approach to compute the BRDF, at the expense of greater computational complexity. In this Letter, nongrazing BRDF measurements of rough and polished surface-reflecting materials at multiple incident angles are scaled by the microfacet cross section conversion term, but in the linear systems direction cosine space, resulting in great alignment of BRDF data at various incident angles in this space. This results in a predictive BRDF model for surface-reflecting materials at nongrazing angles, while avoiding some of the computational complexities in the linear systems diffraction model.

Site investigation SFR. Reprocessing of reflection seismic profiles 5b and 8, Forsmark

Energy Technology Data Exchange (ETDEWEB)

Juhlin, Christopher; Zhang, Fengjiao (Uppsala Univ., Dept. of Earth Sciences (Sweden))

2010-12-15

Reflection seismic profiles 5b and 8 in the northern Forsmark area have been reprocessed with the aim of improving the images in the uppermost 500 metres in the SFR area. The main conclusion is that a new reflection (B10) has been identified that may extend below the SFR site. This reflection was not clearly observed in the previous processing. The reflection strikes approximately N25E and dips at about 35 degrees to the southeast. This orientation is similar to the set B group identified earlier /Juhlin and Palm 2005/. Note that the dip of the reflection is uncertain. On shot gathers it appears to dip at a slightly shallower angle while on the stacked sections it appears to dip at a greater angle. This discrepancy is probably due to the crooked nature of the profiles. However, reflections are clearly observed in shot gathers and its presence below SFR is highly probable. Two new reflections were also identified further north along profile 5b (A11 and A12). These dip to the south-southeast, but would be found at a depth of 1-2 km below SFR if they extend to below the site. There are also signs of a 3rd reflection with similar orientation to the set A group identified earlier, A13, but its existence is very speculative. This reflector would intersect the surface within the SFR area. South of the Singoe deformation zone on profile 5b, another new reflection has been found, N1. The orientation of this reflection is speculative since it is not clearly seen on profile 8. It has been modelled as dipping to the north at about 35 degrees and projects to the surface south of the main SFR area. In addition, the orientation of reflection B7 has been revised as has the lateral extent of A1. Most importantly, A1 is now interpreted not to extend to the surface and not cross the Singoe deformation zone

The comparative effects of group prenatal care on psychosocial outcomes.

Science.gov (United States)

Heberlein, Emily C; Picklesimer, Amy H; Billings, Deborah L; Covington-Kolb, Sarah; Farber, Naomi; Frongillo, Edward A

2016-04-01

To compare the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care, we conducted a prospective cohort study of women who chose CP group (N = 124) or individual prenatal care (N = 124). Study participants completed the first survey at study recruitment (mean gestational age 12.5 weeks), with 89% completing the second survey (mean gestational age 32.7 weeks) and 84% completing the third survey (6 weeks' postpartum). Multiple linear regression models compared changes by prenatal care model in pregnancy-specific distress, prenatal planning-preparation and avoidance coping, perceived stress, affect and depressive symptoms, pregnancy-related empowerment, and postpartum maternal-infant attachment and maternal functioning. Using intention-to-treat models, group prenatal care participants demonstrated a 3.2 point greater increase (p prenatal planning-preparation coping strategies. While group participants did not demonstrate significantly greater positive outcomes in other measures, women who were at greater psychosocial risk benefitted from participation in group prenatal care. Among women reporting inadequate social support in early pregnancy, group participants demonstrated a 2.9 point greater decrease (p = 0.03) in pregnancy-specific distress in late pregnancy and 5.6 point higher mean maternal functioning scores postpartum (p = 0.03). Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 point greater increase (p prenatal planning-preparation coping strategies in late pregnancy and a 4.9 point greater decrease (p = 0.02) in postpartum depressive symptom scores. This study provides further evidence that group prenatal care positively impacts the psychosocial well-being of women with greater stress or lower personal coping resources. Large randomized studies are needed to establish conclusively the biological and psychosocial benefits of group

Higher Physiotherapy Frequency Is Associated with Shorter Length of Stay and Greater Functional Recovery in Hospitalized Frail Older Adults: A Retrospective Observational Study.

Science.gov (United States)

Hartley, P; Adamson, J; Cunningham, C; Embleton, G; Romero-Ortuno, R

2016-01-01

Extra physiotherapy has been associated with better outcomes in hospitalized patients, but this remains an under-researched area in geriatric medicine wards. We retrospectively studied the association between average physiotherapy frequency and outcomes in hospitalized geriatric patients. High frequency physiotherapy (HFP) was defined as ≥0.5 contacts/day. Of 358 eligible patients, 131 (36.6%) received low, and 227 (63.4%) HFP. Functional improvement (discharge versus admission) in the modified Rankin scale was greater in the HFP group (1.1 versus 0.7 points, Pphysiotherapy frequency and intensity in geriatric wards.

Liberating Moral Reflection

Science.gov (United States)

Horell, Harold D.

2013-01-01

The author argues that if we are to foster life-giving and liberating moral reflection, we must first liberate moral reflection from distortions; specifically, from the distorting effects of moral insensitivity, destructive moral relativism, and confusions resulting from a failure to understand the dynamics of moral reflection. The author proposes…

Ultra-wideband high-efficiency reflective linear-to-circular polarization converter based on metasurface at terahertz frequencies.

Science.gov (United States)

Jiang, Yannan; Wang, Lei; Wang, Jiao; Akwuruoha, Charles Nwakanma; Cao, Weiping

2017-10-30

The polarization conversion of electromagnetic (EM) waves, especially linear-to-circular (LTC) polarization conversion, is of great significance in practical applications. In this study, we propose an ultra-wideband high-efficiency reflective LTC polarization converter based on a metasurface in the terahertz regime. It consists of periodic unit cells, each cell of which is formed by a double split resonant square ring, dielectric layer, and fully reflective gold mirror. In the frequency range of 0.60 - 1.41 THz, the magnitudes of the reflection coefficients reach approximately 0.7, and the phase difference between the two orthogonal electric field components of the reflected wave is close to 90° or -270°. The results indicate that the relative bandwidth reaches 80% and the efficiency is greater than 88%, thus, ultra-wideband high-efficiency LTC polarization conversion has been realized. Finally, the physical mechanism of the polarization conversion is revealed. This converter has potential applications in antenna design, EM measurement, and stealth technology.

Ultra-wideband reflective polarization converter based on anisotropic metasurface

Science.gov (United States)

Wu, Jia-Liang; Lin, Bao-Qin; Da, Xin-Yu

2016-08-01

In this paper, we propose an ultra-wideband reflective linear cross-polarization converter based on anisotropic metasurface. Its unit cell is composed of a square-shaped resonator with intersectant diagonal and metallic ground sheet separated by dielectric substrate. Simulated results show that the converter can generate resonances at four frequencies under normal incident electromagnetic (EM) wave, leading to the bandwidth expansion of cross-polarization reflection. For verification, the designed polarization converter is fabricated and measured. The measured and simulated results agree well with each other, showing that the fabricated converter can convert x- or y-polarized incident wave into its cross polarized wave in a frequency range from 7.57 GHz to 20.46 GHz with a relative bandwidth of 91.2%, and the polarization conversion efficiency is greater than 90%. The proposed polarization converter has a simple geometry but an ultra wideband compared with the published designs, and hence possesses potential applications in novel polarization-control devices. Project supported by the National Natural Science Foundation of China (Grant Nos. 61471387, 61271250, and 61571460).

Measurement of refractive indices of tunicates' tunics: light reflection of the transparent integuments in an ascidian Rhopalaea sp. and a salp Thetys vagina.

Science.gov (United States)

Kakiuchida, Hiroshi; Sakai, Daisuke; Nishikawa, Jun; Hirose, Euichi

2017-01-01

Tunic is a cellulosic, integumentary matrix found in tunicates (Subphylum Tunicata or Urochordata). The tunics of some ascidian species and pelagic tunicates, such as salps, are nearly transparent, which is useful in predator avoidance. Transparent materials can be detected visually using light reflected from their surfaces, with the different refractive indices between two media, i.e., tunic and seawater, being the measure of reflectance. A larger difference in refractive indices thus provides a larger measure of reflectance. We measured the refractive indices of the transparent tunic of Thetys vagina (salp: Thaliacea) and Rhopalae a sp. (ascidian: Ascidiacea) using an Abbe refractometer and an ellipsometer to estimate the light reflection at the tunic surface and evaluate the anti-reflection effect of the nipple array structure on the tunic surface of T. vagina . At D-line light (λ = 589 nm), the refractive indices of the tunics were 0.002-0.004 greater than seawater in the measurements by Abbe refractometer, and 0.02-0.03 greater than seawater in the measurements by ellipsometer. The refractive indices of tunics were slightly higher than that of seawater. According to the simulation of light reflection based on rigorous coupled wave analysis (RCWA), light at a large angle of incidence will be completely reflected from a surface when its refractive indices are smaller than seawater. Therefore, the refractive index of integument is important for enabling transparent organisms to remain invisible in the water column. In order to minimize reflectance, the refractive index should be similar to, but never smaller than, that of the surrounding seawater. The simulation also indicated that the presence or absence of a nipple array does not cause significant difference in reflectance on the surface. The nipple array on the tunic of the diurnal salp may have another function, such as bubble repellence, other than anti-reflection.

Neurodevelopmental outcomes of near-term small-for-gestational-age infants with and without signs of placental underperfusion.

Science.gov (United States)

Parra-Saavedra, Miguel; Crovetto, Francesca; Triunfo, Stefania; Savchev, Stefan; Peguero, Anna; Nadal, Alfons; Parra, Guido; Gratacos, Eduard; Figueras, Francesc

2014-04-01

To evaluate 2-year neurodevelopmental outcomes of near-term, small-for-gestational-age (SGA) newborns segregated by presence or absence of histopathology reflecting placental underperfusion (PUP). A cohort of consecutive near-term (≥ 34.0 weeks) SGA newborns with normal prenatal umbilical artery Doppler studies was selected. All placentas were inspected for evidence of underperfusion and classified in accordance with established histologic criteria. Neurodevelopmental outcomes at 24 months (age-corrected) were then evaluated, applying the Bayley Scale for Infant and Toddler Development, Third Edition (Bayley-III) to assess cognitive, language, and motor competencies. The impact of PUP on each domain was measured via analysis of covariance, logistic and ordinal regression, with adjustment for smoking, socioeconomic status, gestational age at birth, gender, and breastfeeding. A total of 83 near-term SGA deliveries were studied, 46 (55.4%) of which showed signs of PUP. At 2 years, adjusted neurodevelopmental outcomes were significantly poorer in births involving PUP (relative to SGA infants without PUP) for all three domains of the Bayley scale: cognitive (105.5 vs 96.3, adjusted-p = 0.03), language (98.6 vs 87.8, adjusted-p<0.001), and motor (102.7 vs 94.5, adjusted-p = 0.007). Similarly, the adjusted likelihood of abnormal cognitive, language, and motor competencies in instances of underperfusion was 9.3-, 17.5-, and 1.44-fold higher, respectively, differing significantly for the former two domains. In a substantial fraction of near-term SGA babies without Doppler evidence of placental insufficiency, histologic changes compatible with PUP are still identifiable. These infants are at greater risk of abnormal neurodevelopmental outcomes at 2 years. Copyright © 2014 Elsevier Ltd. All rights reserved.

Reflection ciphers

DEFF Research Database (Denmark)

Boura, Christina; Canteaut, Anne; Knudsen, Lars Ramkilde

2017-01-01

study the necessary properties for this coupling permutation. Special care has to be taken of some related-key distinguishers since, in the context of reflection ciphers, they may provide attacks in the single-key setting.We then derive some criteria for constructing secure reflection ciphers...

Correlations between colonization of onion thrips and leaf reflectance measures across six cabbage varieties.

Directory of Open Access Journals (Sweden)

János Bálint

Full Text Available The main purpose of this study was to reveal if the UV-A, and visible light reflection of leaves of white cabbage varieties is correlated to resistance against onion thrips. The antixenotic resistance (AR against onion thrips and thrips damage differed between varieties Balashi, Bloktor, Riana - considered resistant - and Green Gem, Hurricane, Quisor - considered susceptible. The solar UV-A (340-400 nm and visible (401-650 nm light reflection of white cabbage leaves were recorded. Correlation between AR against onion thrips and reflection of leaves in UV-A and visible range of the studied white cabbage varieties were computed. According to the AR evaluation onion thrips density was always higher on susceptible than on resistant varieties. The UV-A light reflection of head forming leaves and the contrast between head and exterior leaves (H/E was negatively correlated with onion thrips host preference at an early stage of cabbage head formation. The visible light reflection of both head forming and exterior leaves was also negatively correlated with onion thrips host preference. Susceptible varieties had greater damage ratings at harvest than resistant ones and positive correlations were observed between AR and damage. AR against onion thrips may be affected by differences in reflection of cabbage leaves at an early growth stage. It is suggested that more intensive reflection of leaves and/or higher contrast values between the reflectance intensity of head versus outer leaves made the resistant varieties less attractive to onion thrips. Our results reported here provide the first evidence of negative correlation between UV-A and visible reflection of leaves and AR of white cabbage against a dangerous insect pest, opening new perspectives for understanding the role of reflection by plant leaves in pest management.

Greater hunger and less restraint predict weight loss success with phentermine treatment.

Science.gov (United States)

Thomas, Elizabeth A; Mcnair, Bryan; Bechtell, Jamie L; Ferland, Annie; Cornier, Marc-Andre; Eckel, Robert H

2016-01-01

Phentermine is thought to cause weight loss through a reduction in hunger. It was hypothesized that higher hunger ratings would predict greater weight loss with phentermine. This is an observational pilot study in which all subjects were treated with phentermine for 8 weeks and appetite and eating behaviors were measured at baseline and week 8. Outcomes were compared in subjects with ≥5% vs. hunger (P = 0.017), desire to eat (P =0.003), and prospective food consumption (0.006) and lower baseline cognitive restraint (P = 0.01). In addition, higher baseline home prospective food consumption (P = 0.002) and lower baseline cognitive restraint (P hunger and less restraint are more likely to achieve significant weight loss with phentermine. This information can be used clinically to determine who might benefit most from phentermine treatment. © 2015 The Obesity Society.

Prospective impact of illness uncertainty on outcomes in chronic lung disease.

Science.gov (United States)

Hoth, Karin F; Wamboldt, Frederick S; Strand, Matthew; Ford, Dee W; Sandhaus, Robert A; Strange, Charlie; Bekelman, David B; Holm, Kristen E

2013-11-01

To determine which aspect of illness uncertainty (i.e., ambiguity or complexity) has a stronger association with psychological and clinical outcomes over a 2-year period among individuals with a genetic subtype of chronic obstructive pulmonary disease (COPD). Ambiguity reflects uncertainty about physical cues and symptoms, and complexity reflects uncertainty about treatment and the medical system. Four-hundred and 7 individuals with alpha-1 antitrypsin deficiency-associated COPD completed questionnaires at baseline, 1- and 2-year follow-up. Uncertainty was measured using the Mishel Uncertainty in Illness Scale. Outcomes were measured using the Hospital Anxiety and Depression Scale, St. George's Respiratory Questionnaire, and MMRC Dyspnea Scale. Ambiguity and complexity were examined as predictors of depressive symptoms, anxiety, quality of life, and breathlessness using linear mixed models adjusting for demographic and health characteristics. Ambiguity was associated with more depressive symptoms (b = 0.09, SE = 0.02, p life (b = 0.57, SE = 0.10, p life, and breathlessness. Thus, ambiguity should be targeted in psychosocial interventions. Time since diagnosis did not affect the association between ambiguity and outcomes, suggesting that the impact of ambiguity is equally strong throughout the course of COPD.

Evaluation of retro-reflective coating performance by reflectance and perceived relative brightness measurements

International Nuclear Information System (INIS)

Luse, Kaiva; Pausus, Anete; Karitans, Varis; Ozolins, Maris; Tukisa, Madara

2011-01-01

Retro-reflective properties of six types and five different colors or retro-reflective materials were discussed in this paper. Reflectance optical indicatrix of samples was determined and compared to obtained psychophyisical data of perceived brightness of human observer. Microscopic structure of the retro-reflective active regions of RR's was studied. Statistically significant differences in reflectivity and brightness of various types and colors of RR's were found.

The effects of positive versus negative impact reflection on change in job performance and work-life conflict.

Science.gov (United States)

Cardador, M Teresa

2014-01-01

Research on task significance and relational job design suggests that information from beneficiaries of one's work fosters perceptions of impact, and thus improved work outcomes. This paper presents results from a longitudinal field experiment examining the effect of another strategy for fostering perceptions of impact - engaging employees in regular reflection about how their work benefits others. With a sample of professionals from multiple organizations, this longitudinal study examined the effect on job performance and work-life conflict of both positive and negative impact reflection. Results show that negative impact reflection had a pronounced negative effect on job performance, but no effect on work-life conflict. Positive impact reflection had a weak positive effect on work-life conflict, but no significant effect on job performance. The direction of effects seen in the no intervention condition mirrored that of the negative impact reflection condition, suggesting a possible buffering effect for positive impact reflection. This research provides empirical and theoretical contributions to the literatures on relational job design and task significance.

Optimism and spontaneous self-affirmation are associated with lower likelihood of cognitive impairment and greater positive affect among cancer survivors

Science.gov (United States)

Taber, Jennifer M.; Klein, William M. P.; Ferrer, Rebecca A.; Kent, Erin E.; Harris, Peter R.

2016-01-01

Background Optimism and self-affirmation promote adaptive coping, goal achievement, and better health. Purpose To examine the associations of optimism and spontaneous self-affirmation (SSA) with physical, mental, and cognitive health and information seeking among cancer survivors. Methods Cancer survivors (n=326) completed the Health Information National Trends Survey 2013, a national survey of U.S. adults. Participants reported optimism, SSA, cognitive and physical impairment, affect, health status, and information seeking. Results Participants higher in optimism reported better health on nearly all indices examined, even when controlling for SSA. Participants higher in SSA reported lower likelihood of cognitive impairment, greater happiness and hopefulness, and greater likelihood of cancer information seeking. SSA remained significantly associated with greater hopefulness and cancer information seeking when controlling for optimism. Conclusions Optimism and SSA may be associated with beneficial health-related outcomes among cancer survivors. Given the demonstrated malleability of self-affirmation, these findings represent important avenues for future research. PMID:26497697

Optimism and Spontaneous Self-affirmation are Associated with Lower Likelihood of Cognitive Impairment and Greater Positive Affect among Cancer Survivors.

Science.gov (United States)

Taber, Jennifer M; Klein, William M P; Ferrer, Rebecca A; Kent, Erin E; Harris, Peter R

2016-04-01

Optimism and self-affirmation promote adaptive coping, goal achievement, and better health. The aim of this study is to examine the associations of optimism and spontaneous self-affirmation (SSA) with physical, mental, and cognitive health and information seeking among cancer survivors. Cancer survivors (n = 326) completed the Health Information National Trends Survey 2013, a national survey of US adults. Participants reported optimism, SSA, cognitive and physical impairment, affect, health status, and information seeking. Participants higher in optimism reported better health on nearly all indices examined, even when controlling for SSA. Participants higher in SSA reported lower likelihood of cognitive impairment, greater happiness and hopefulness, and greater likelihood of cancer information seeking. SSA remained significantly associated with greater hopefulness and cancer information seeking when controlling for optimism. Optimism and SSA may be associated with beneficial health-related outcomes among cancer survivors. Given the demonstrated malleability of self-affirmation, these findings represent important avenues for future research.

Examining an underlying mechanism between perceived stress and smoking cessation-related outcomes.

Science.gov (United States)

Robles, Zuzuky; Garey, Lorra; Hogan, Julianna; Bakhshaie, Jafar; Schmidt, Norman B; Zvolensky, Michael J

2016-07-01

The mediational role of negative reinforcement smoking outcome expectancies in the relation between perceived stress and (1) perceived barriers to cessation, (2) severity of problematic symptoms during past quit attempts, and (3) smoking-specific experiential avoidance (AIS) was examined. Data were drawn from a baseline assessment of a larger clinical trial. Participants included 332 adult treatment-seeking smokers (47.3% female; Mage=38.45; SD=.50; age range: 18-65 years). Results indicated that perceived stress was indirectly related to perceived barriers to smoking cessation, severity of problematic symptoms during past quit attempts, and AIS through negative reinforcement outcome expectancies. These results were evident after accounting for the variance explained by gender, negative affectivity, and alternative outcome expectancies for smoking. The present findings suggest that smokers with greater perceived stress experience greater negative reinforcement smoking expectancies, which in turn, may be related to numerous processes involved in the maintenance of smoking. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reflective writing: the student nurse's perspective on reflective writing and poetry writing.

Science.gov (United States)

Coleman, Dawn; Willis, Diane S

2015-07-01

Reflective writing is a mandatory part of nurse education but how students develop their skills and use reflection as part of their experiential learning remains relatively unknown. Understanding reflective writing in all forms from the perspective of a student nurse is therefore important. To explore the use of reflective writing and the use of poetry in pre-registered nursing students. A qualitative design was employed to explore reflective writing in pre-registered nursing students. A small university in Scotland. BSc (Hons) Adult and Mental Health Pre-registration Student Nurses. Two focus groups were conducted with 10 student nurses during March 2012. Data was analysed thematically using the framework of McCarthy (1999). Students found the process of reflective writing daunting but valued it over time. Current educational methods, such as assessing reflective accounts, often lead to the 'narrative' being watered down and the student feeling judged. Despite this, reflection made students feel responsible for their own learning and research on the topic. Some students felt the use of models of reflection constricting, whilst poetry freed up their expression allowing them to demonstrate the compassion for their patient under their care. Poetry writing gives students the opportunity for freedom of expression, personal satisfaction and a closer connection with their patients, which the more formal approach to reflective writing did not offer. There is a need for students to have a safe and supportive forum in which to express and have their experiences acknowledged without the fear of being judged. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Reflecting on healthcare and self-care in the Intensive Care Unit: our story

Directory of Open Access Journals (Sweden)

Allan Peterkin

2014-12-01

Full Text Available Health care professionals working in Intensive Care Units (ICUs are exposed to high levels of stress-provoking stimuli. Some may unconsciously employ negative coping skill s which may contribute to burnout and negatively affect patient care. We chose to explore ways of facilitating and encouraging self-reflective practice in an effort to increase empathic traits and enhance communication. A narrative medicine series, which included six sessions that were focused on different narrative approaches, was organized for staff of an academic teaching hospital. Totally, 132 interdisciplinary ICU staff attended the sessions. They were generally open to exploring the selected approaches and discussing their reflections within the interdisciplinary environment. The narrative medicine series provided tools for health care professionals to enhance self-reflective skills utilizing a team-based learning approach. The anticipated outcomes were improved self-care, increased empathy and communication skills, enhanced team functioning, which all contribute to better patient care at the bedside.

Low-dose external beam radiotherapy for greater trochanteric pain syndrome. Target volume definition and treatment outcome

Energy Technology Data Exchange (ETDEWEB)

Kaltenborn, Alexander [Federal Armed Forces Hospital Westerstede, Department of Orthopedic and Trauma Surgery, Westerstede (Germany); Hannover Medical School, Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover (Germany); Carl, Ulrich Martin; Hinsche, Tanja [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); Nitsche, Mirko [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); University of Schleswig Holstein, Campus Kiel, Department of Radiotherapy, Karl-Lennert Cancer Center, Kiel (Germany); Hermann, Robert Michael [Center for Radiotherapy and Radiooncology Bremen and Westerstede, Westerstede (Germany); Hannover Medical School, Department of Radiotherapy and Special Oncology, Hannover (Germany)

2017-04-15

Low-dose external beam radiotherapy (ED-EBRT) is frequently used in the therapy of refractory greater trochanteric pain syndrome (GTPS). As studies reporting treatment results are scarce, we retrospectively analyzed our own patient collectives. In all, 60 patients (74 hips) received LD-EBRT (6 x 0.5 Gy in 29 hips, 6 x 1 Gy in 45). The endpoint was the patient's reported subjective response to treatment. The influence of different patient and treatment characteristics on treatment outcome was investigated. At the end of LD-EBRT, 69% reported partial remission, 4% complete remission, no change 28%. A total of 3 months later (n = 52 hips), the results were 37, 33, and 30% and 18 months after LD-EBRT (n = 47) 21, 51, and 28%. In univariate analysis ''inclusion of the total femoral head into the PTV'' and ''night pain before LD-EBRT'' were correlated with symptom remission at the end of LD-EBRT, while ''initial increase in pain during LD-EBRT'' was significantly associated with treatment failure. In multivariable modeling ''initial increase in pain'' was identified as a risk factor for treatment failure (p = 0.007; odds ratio [OR] 0.209; 95% confidence interval [CI] 0.048-0.957), while ''night pain'' was an independent factor for remission (p = 0.038; OR 3.484; 95% CI 1.004-12.6). Three months after LD-EBRT ''night pain'' and ''inclusion of the complete femoral neck circumference into the PTV'' were predictive for remission. LD-EBRT represents a useful treatment option for patients suffering from GTPS. Three months after therapy two-thirds of the patients reported a partial or complete symptom remission. Especially patients who suffered from nocturnal pain seemed to benefit. Treatment appeared to be more effective when the entire circumference of the femoral neck was encompassed. (orig.) [German] In der Behandlung des

Paranoid individuals with schizophrenia show greater social cognitive bias and worse social functioning than non-paranoid individuals with schizophrenia

OpenAIRE

Amy E. Pinkham; Philip D. Harvey; David L. Penn

2016-01-01

Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid indiv...

Greater trochanteric pain syndrome diagnosis and treatment.

Science.gov (United States)

Mallow, Michael; Nazarian, Levon N

2014-05-01

Lateral hip pain, or greater trochanteric pain syndrome, is a commonly seen condition; in this article, the relevant anatomy, epidemiology, and evaluation strategies of greater trochanteric pain syndrome are reviewed. Specific attention is focused on imaging of this syndrome and treatment techniques, including ultrasound-guided interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

Stroke outcomes in Northern Scotland: does rurality really matter?

Science.gov (United States)

O'Neill, N P; Godden, D J

2003-01-01

settlements being admitted to community hospitals and remaining there at 6 months may reflect greater availability of community hospital places in this settlement category, but may also be influenced by stroke severity. The low uptake of rehabilitation and support services generally, combined with the relatively poor functional outcome of our patients, suggests that there may be an unmet need for rehabilitation. However, rural patients did not appear specifically disadvantaged. Our study indicates that patients developing a first-time stroke in remote and rural areas of the Highlands and Islands of Scotland are not disadvantaged compared to those in urban/accessible areas, with respect to outcome or to the utilization of health and social care services. However, functional outcomes could be improved for patients in all settlement categories.

Evaluation of retro-reflective coating performance by reflectance and perceived relative brightness measurements

Energy Technology Data Exchange (ETDEWEB)

Luse, Kaiva; Pausus, Anete; Karitans, Varis; Ozolins, Maris; Tukisa, Madara, E-mail: kaiva.luse@gmail.com [University of Latvia, Optometry and Vision Science Department, Kengaraga street 8, Riga LV-1063 (Latvia)

2011-06-23

Retro-reflective properties of six types and five different colors or retro-reflective materials were discussed in this paper. Reflectance optical indicatrix of samples was determined and compared to obtained psychophyisical data of perceived brightness of human observer. Microscopic structure of the retro-reflective active regions of RR's was studied. Statistically significant differences in reflectivity and brightness of various types and colors of RR's were found.

Sociocultural patterning of neural activity during self-reflection.

Science.gov (United States)

Ma, Yina; Bang, Dan; Wang, Chenbo; Allen, Micah; Frith, Chris; Roepstorff, Andreas; Han, Shihui

2014-01-01

Western cultures encourage self-construals independent of social contexts, whereas East Asian cultures foster interdependent self-construals that rely on how others perceive the self. How are culturally specific self-construals mediated by the human brain? Using functional magnetic resonance imaging, we monitored neural responses from adults in East Asian (Chinese) and Western (Danish) cultural contexts during judgments of social, mental and physical attributes of themselves and public figures to assess cultural influences on self-referential processing of personal attributes in different dimensions. We found that judgments of self vs a public figure elicited greater activation in the medial prefrontal cortex (mPFC) in Danish than in Chinese participants regardless of attribute dimensions for judgments. However, self-judgments of social attributes induced greater activity in the temporoparietal junction (TPJ) in Chinese than in Danish participants. Moreover, the group difference in TPJ activity was mediated by a measure of a cultural value (i.e. interdependence of self-construal). Our findings suggest that individuals in different sociocultural contexts may learn and/or adopt distinct strategies for self-reflection by changing the weight of the mPFC and TPJ in the social brain network.

Unlocking reflective practice for nurses: innovations in working with master of nursing students in Hong Kong.

Science.gov (United States)

Joyce-McCoach, Joanne T; Parrish, Dominique R; Andersen, Patrea R; Wall, Natalie

2013-09-01

Being reflective is well established as an important conduit of practice development, a desirable tertiary graduate quality and a core competency of health professional membership. By assisting students to be more effective in their ability to reflect, they are better able to formulate strategies to manage issues experienced within a professional context, which ultimately assists them to be better service providers. However, some students are challenged by the practice of reflection and these challenges are even more notable for international students. This paper presents a teaching initiative that focused specifically on enhancing the capacity of an international cohort of nursing students, to engage in reflective practice. The initiative centered on an evaluation of a reflective practice core subject, which was taught in a Master of Nursing programme delivered in Hong Kong. A learning-centered framework was used to evaluate the subject and identify innovative strategies that would better assist international students to develop reflective practices. The outcomes of curriculum and teaching analysis and proposed changes and innovations in teaching practice to support international students are presented and discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Reflection as Self-Assessment

Science.gov (United States)

Pappas, Marjorie L.

2010-01-01

In this article, the author discusses how reflection can be used as self-assessment. Reflection involves not only thinking about a learning experience, but also questioning parts of the experience. Reflection is thinking about what one knows from the learning experience, what one might do differently the next time. Reflection is wondering about…

Operational technology for greater confinement disposal

International Nuclear Information System (INIS)

Dickman, P.T.; Vollmer, A.T.; Hunter, P.H.

1984-12-01

Procedures and methods for the design and operation of a greater confinement disposal facility using large-diameter boreholes are discussed. It is assumed that the facility would be located at an operating low-level waste disposal site and that only a small portion of the wastes received at the site would require greater confinement disposal. The document is organized into sections addressing: facility planning process; facility construction; waste loading and handling; radiological safety planning; operations procedures; and engineering cost studies. While primarily written for low-level waste management site operators and managers, a detailed economic assessment section is included that should assist planners in performing cost analyses. Economic assessments for both commercial and US government greater confinement disposal facilities are included. The estimated disposal costs range from $27 to $104 per cubic foot for a commercial facility and from $17 to $60 per cubic foot for a government facility. These costs are based on average site preparation, construction, and waste loading costs for both contact- and remote-handled wastes. 14 figures, 22 tables

In-center hemodialysis absenteeism: prevalence and association with outcomes

Directory of Open Access Journals (Sweden)

Gray KS

2017-05-01

Full Text Available Kathryn S Gray, Dena E Cohen, Steven M Brunelli DaVita Clinical Research, Minneapolis, MN, USA Objective: The aim of this study was to determine the rate of missed treatments among hemodialysis (HD patients, and the association between treatment nonadherence and clinical outcomes.Data source: The data used in this study were based on electronic medical records and Medicare claims.Study design: This is a retrospective, observational study.Principal findings: HD patients miss 9.9% of all treatments. Approximately half of the missed treatments are due to observable medical events, predominantly hospitalizations, while half result from nonadherence (“absence”. A single absence is associated with a 1.4-fold greater risk of hospitalization, and a 2.2-fold greater risk of death in the subsequent 30 days.Conclusion: Treatment nonadherence is common among HD patients and is associated with adverse outcomes. Interventions that improve adherence may improve patient health and reduce costs. Keywords: Medicare, ambulatory/outpatient care, epidemiology, chronic disease

Designing a Reflective Teacher Education Course and Its Contribution to ELT Teachers' Reflectivity

Science.gov (United States)

Tajik, Leila; Pakzad, Kazem

2016-01-01

Researchers in the present study planned a reflective teacher education course and documented the contribution of such a course to improving teachers' reflectivity. Five English teachers took part in the reflective teacher education course designed by the researchers. To record how the course could help improve reflective teaching, researchers…

Reflective functioning, physiological reactivity, and overcontrol in mothers: Links with school-aged children's reflective functioning.

Science.gov (United States)

Borelli, Jessica L; Hong, Kajung; Rasmussen, Hannah F; Smiley, Patricia A

2017-09-01

Theorists argue that parental reflective functioning (PRF) is activated in response to emotions, potentially supporting parenting sensitivity even when arousal is high. That is, when parents become emotionally reactive when interacting with their children, those who can use PRF to understand their children's mental states should be able to parent sensitively, which, in turn, should promote children's ability to understand their own mental states. We test this theory by examining whether, in the face of physiological reactivity, mothers' PRF inhibits one form of parenting insensitivity, overcontrol (OC), and whether this process in turn predicts children's RF. A diverse sample of school-age children (N = 106, Mage = 10.27 years) completed a standardized failure paradigm while their mothers were asked to passively observe. Following the stressor, mothers and children independently completed interviews regarding the task, which were later coded for RF with respect to children's mental states. Mothers provided saliva samples before and after the stressor, and after the interview, which were later assayed for cortisol reactivity; maternal behavior during the stressor task was coded for OC. Among mothers with low levels of RF, greater increases in cortisol were associated with more displays of OC, whereas among mothers with high PRF, greater cortisol reactivity was associated with fewer OC behaviors. For low PRF mothers, higher reactivity and OC predicted lower children's PRF for their own experiences. The findings provide initial evidence for a protective function of PRF, and may point toward the importance of promoting PRF in intervention programs to reduce parental OC. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Self-reflection of extremely short light pulses in nonlinear optical waveguides

Science.gov (United States)

Kurasov, Alexander E.; Kozlov, Sergei A.

2004-07-01

An equation describing the generation of reflected radiation during the propagation of high-intensity extremely short pulses in a nonlinear optical waveguide is derived. The phenomena taking place during the strong self-inducted changes of the temporal structure of the forward wave are studied. It is shown that the duration of the backward pulse is much greater than the duration of the forward pulse and that the main part of the energy of the backward wave is carried by lower frequencies than the central frequency of the forward wave.

Self-Reflection

DEFF Research Database (Denmark)

Fausing, Bent

2016-01-01

will take a look at the establishing of the modern self and possibilities of self-reflection, too. My examples will be from the so-called dark-selfies and from a new selfie form, which merge the present with the previous progressing into the future. I will discuss the media reflections as loos and/or gain...

Personal Reflections

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education. Personal Reflections. Articles in Resonance – Journal of Science Education. Volume 6 Issue 3 March 2001 pp 90-93 Personal Reflections. Why did I opt for Career in Science? Jayant V Narlikar · More Details Fulltext PDF. Volume 9 Issue 8 August 2004 pp 89-89 ...

Disparities in operative outcomes in patients with comorbid mental illness.

Science.gov (United States)

Bailey, Elizabeth A; Wirtalla, Christopher; Sharoky, Catherine E; Kelz, Rachel R

2018-04-01

Patients with mental health disorders have worse medical outcomes and experience excess mortality compared with those without a mental health comorbidity. This study aimed to evaluate the relationship between mental health comorbidities and surgical outcomes. This retrospective cohort study used the National Inpatient Sample (2009-2011) to select patients who underwent one of the 4 most common general surgery procedures (cholecystectomy and common duct exploration, colorectal resection, excision and lysis of peritoneal adhesions, and appendectomy). Patients with a concurrent mental health diagnosis were identified. Multivariable logistic regression examined outcomes, including prolonged length of stay, in-hospital mortality, and postoperative complications. Of the 579,851 patients included, 38,702 patients (6.7%) had a mental health diagnosis. Mood disorders were most prevalent (58.7%), followed by substance abuse (23.8%). After adjustment for confounders, including sex, race, number of comorbidities, admission status, open operations, insurance, and income quartile, we found that having a mental health diagnosis conferred a 40% greater odds of including prolonged length of stay (OR 1.41, P mental health diagnosis cohort. General surgery patients with comorbid mental disease experience a greater incidence of postoperative complications and longer hospitalizations. Recognizing these disparate outcomes is the first step in understanding how to optimize care for this frequently marginalized population. Copyright © 2017 Elsevier Inc. All rights reserved.

Marital Dissolution and Child Educational Outcomes in San Borja, Bolivia.

Science.gov (United States)

Snopkowski, Kristin

2016-12-01

Serial monogamy is likely an adaptive mating strategy for women when the expected future fitness gains with a different partner are greater than expected future fitness with one's current partner. Using interview data from more than 400 women in San Borja, Bolivia, discrete-time event history analyses and random effects regression analyses were conducted to examine predictors of marital dissolution, separated by remarriage status, and child educational outcomes. Male income was found to be inversely associated with women's risk of "divorce and remarriage," whereas female income is positively associated with women's risk of "divorce, but not remarriage." Children of women who divorce and remarry tend to have significantly lower educational outcomes than children of married parents, but women with higher incomes are able to buffer their children from the negative educational outcomes of divorce and remarriage. Counter to predictions, there is no evidence that women with kin in the community have a significant difference in likelihood of divorce or a buffering effect of child outcomes. In conclusion, predictors of divorce differ depending on whether the woman goes on to remarry, suggesting that male income may be a better predictor of a serial monogamy strategy whereas female income predicts marital dissolution only. Thus, women who are relatively autonomous because of greater income may not benefit from remarriage.

Lord Sainsbury announces outcome of Research Council review

CERN Multimedia

Dept. Trade & Industry

2002-01-01

Science and Innovation Minister, Lord Sainsbury, today announced the outcome of a review of the Council for the Central Laboratory of the Research Councils (CCLRC). The report is the second stage of a five-yearly review, which outlines ways to strengthen and promote greater value for money from the UK's investment in science (1 page).

A study of the anti-reflection efficiency of natural nano-arrays of varying sizes

International Nuclear Information System (INIS)

Sun Mingxia; Liang Aiping; Zheng Yongmei; Watson, Gregory S; Watson, Jolanta A

2011-01-01

The dependence of optical reflectivity and wettability on the surface topography of 32 species of cicada wing membranes has been investigated using UV-visible spectrophotometry, contact angle measurements and environmental scanning electron microscopy. The nanoscale hexagonally close packed protrusions have been shown to exhibit an anti-reflection and in some cases an anti-wetting function. The parameters of the structures were measured to be 77-148 nm in diameter, 44-117 nm in spacing and 159-481 nm in height. The transmittance spectrum and static contact angles were measured. At a wavelength range of 500-2500 nm, only minor differences in the anti-reflection performance were observed for each cicada species ascribed to the mechanism of impedance matching between cuticle and air. The transmittance properties of cicada wings were altered successfully through the scanning probe microscope-based manipulation by reducing the protrusion height via the contact mode. A near linear dependence was found between a decrease in protuberance height and a resulting increase in reflectance intensity. A diversity of wettability was observed with contact angles varying from 56.5 0 to 146.0 0 . Both effects of anti-reflection and wettability are dependent on the height of protrusions. The anti-reflection is insensitive when the wavelength is larger than the lateral feature size of the nanostructure. The stronger hydrophobic properties are generally associated with a larger diameter, closer spacing and greater height of protrusions when the wing membrane is intact.

Application of a two-region kinetic model for reflected reactors to experimental data

International Nuclear Information System (INIS)

Busch, R.D.; Spriggs, G.D.; Williams, J.G.

1996-01-01

Reflected reactors constitute one of the most important classes of nuclear reactors. Yet, during the past 50 yr, a plethora of experimental data involving reflected systems has been reported in the literature that cannot be satisfactorily explained using the open-quotes standardclose quotes (i.e., one-region) point-kinetic model. In particular, many have observed that the prompt-decay a curves obtained from Rossi-α and pulsed-neutron experiments can exhibit multiple decay modes in the vicinity near delayed critical in some types of reflected systems. When analyzed using theories based on the standard point-kinetic model, these data yielded system lifetimes that do not always agree well with the lifetimes predicted by numerical solutions of the multigroup, multidimensional diffusion or transport equations. In several cases, when the longest lived decay mode (i.e., the dominant root) was plotted as a function of reactivity, the a curve intercepted the reactivity axis at a reactivity significantly greater than 1$. Brunson dubbed this seemingly inexplicable behavior as the open-quotes dollar discrepancy.close quotes Furthermore, it has also been observed that the kinetic behavior of some reflected, fast-burst assemblies exhibits a very pronounced nonlinear relationship between reactivity and the initial inverse period for reactivity insertions > 1 $

Neurophysiological prediction of neurological good and poor outcome in post-anoxic coma.

Science.gov (United States)

Grippo, A; Carrai, R; Scarpino, M; Spalletti, M; Lanzo, G; Cossu, C; Peris, A; Valente, S; Amantini, A

2017-06-01

Investigation of the utility of association between electroencephalogram (EEG) and somatosensory-evoked potentials (SEPs) for the prediction of neurological outcome in comatose patients resuscitated after cardiac arrest (CA) treated with therapeutic hypothermia, according to different recording times after CA. Glasgow Coma Scale, EEG and SEPs performed at 12, 24 and 48-72 h after CA were assessed in 200 patients. Outcome was evaluated by Cerebral Performance Category 6 months after CA. Within 12 h after CA, grade 1 EEG predicted good outcome and bilaterally absent (BA) SEPs predicted poor outcome. Because grade 1 EEG and BA-SEPs were never found in the same patient, the recording of both EEG and SEPs allows us to correctly prognosticate a greater number of patients with respect to the use of a single test within 12 h after CA. At 48-72 h after CA, both grade 2 EEG and BA-SEPs predicted poor outcome with FPR=0.0%. When these neurophysiological patterns are both present in the same patient, they confirm and strengthen their prognostic value, but because they also occurred independently in eight patients, poor outcome is predictable in a greater number of patients. The combination of EEG/SEP findings allows prediction of good and poor outcome (within 12 h after CA) and of poor outcome (after 48-72 h). Recording of EEG and SEPs in the same patients allows always an increase in the number of cases correctly classified, and an increase of the reliability of prognostication in a single patient due to concordance of patterns. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Transformational leadership: application of magnet's new empiric outcomes.

Science.gov (United States)

Meredith, Erin K; Cohen, Elaine; Raia, Lucille V

2010-03-01

The many benefits to hospitals throughout the world that achieved Magnet designation is well documented. This status of recognition demands the support of leadership during the Magnet journey. In 2008, the American Nurses Credentialing Center (ANCC) announced a new model for the Magnet Recognition Program that translates the original 14 Forces of Magnetism into Five Model Components. Specifically, this new model includes sources of evidence and empiric outcomes that by definition accentuates transformational nursing leadership. The day-to-day impact of this change places an even greater emphasis on demonstrated outcomes and innovation that may potentially transform nursing practice, quality and safety of care, and the population served. This article provides tangible examples and outcomes for reaching nursing excellence through leadership support and engagement. Published by Elsevier Inc.

Outcome dependency alters the neural substrates of impression formation

Science.gov (United States)

Ames, Daniel L.; Fiske, Susan T.

2015-01-01

How do people maintain consistent impressions of other people when other people are often inconsistent? The present research addresses this question by combining recent neuroscientific insights with ecologically meaningful behavioral methods. Participants formed impressions of real people whom they met in a personally involving situation. fMRI and supporting behavioral data revealed that outcome dependency (i.e., depending on another person for a desired outcome) alters previously identified neural dynamics of impression formation. Consistent with past research, a functional localizer identified a region of dorsomedial PFC previously linked to social impression formation. In the main task, this ROI revealed the predicted patterns of activity across outcome dependency conditions: greater BOLD response when information confirmed (vs. violated) social expectations if participants were outcome-independent and the reverse pattern if participants were outcome-dependent. We suggest that, although social perceivers often discount expectancy-disconfirming information as noise, being dependent on another person for a desired outcome focuses impression-formation processing on the most diagnostic information, rather than on the most tractable information. PMID:23850465

Surgeons’ Volume-Outcome Relationship for Lobectomies and Wedge Resections for Cancer Using Video-Assisted Thoracoscopic Techniques

Directory of Open Access Journals (Sweden)

Guy David

2012-01-01

Full Text Available This study examined the effect of surgeons’ volume on outcomes in lung surgery: lobectomies and wedge resections. Additionally, the effect of video-assisted thoracoscopic surgery (VATS on cost, utilization, and adverse events was analyzed. The Premier Hospital Database was the data source for this analysis. Eligible patients were those of any age undergoing lobectomy or wedge resection using VATS for cancer treatment. Volume was represented by the aggregate experience level of the surgeon in a six-month window before each surgery. A positive volume-outcome relationship was found with some notable features. The relationship is stronger for cost and utilization outcomes than for adverse events; for thoracic surgeons as opposed to other surgeons; for VATS lobectomies rather than VATS wedge resections. While there was a reduction in cost and resource utilization with greater experience in VATS, these outcomes were not associated with greater experience in open procedures.

Do writing and storytelling skill influence assessment of reflective ability in medical students' written reflections?

Science.gov (United States)

Aronson, Louise; Niehaus, Brian; DeVries, Charlie D; Siegel, Jennifer R; O'Sullivan, Patricia S

2010-10-01

Increasingly, students are asked to write reflections as part of their medical education, but some question the influence of other factors on the evaluation of these reflections. In this pilot study, the investigators determined whether scores from a validated rubric to measure reflective ability were affected by irrelevant variance resulting from writing or storytelling ability. Students in clerkships wrote reflections on professionalism. All were given identical prompts, with half receiving additional structured guidelines on reflection. Sixty reflections, 30 from each group, were randomly chosen and scored for reflection, writing, and storytelling by trained raters using validated rubrics. There was no correlation between reflection and either writing (r = 0.049, P = .35) or storytelling (r = 0.14, P = .13). The guidelines increased reflection, but not writing or storytelling scores. Reflection is a distinct construct unaffected by learners' writing or storytelling skills. These findings support reflective ability as a distinct skill.

Greater Trochanteric Fixation Using a Cable System for Partial Hip Arthroplasty: A Clinical and Finite Element Analysis

Science.gov (United States)

Ozan, Fırat; Koyuncu, Şemmi; Pekedis, Mahmut; Altay, Taşkın; Yıldız, Hasan; Toker, Gökhan

2014-01-01

The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women) was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA). Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%), good in 17 patients (53.1%), average in 5 patients (15.6%), and poor in 1 patient (9.3%). Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%), fibrous union in 12 (37.5%), and no union in 6 (18.7%). FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery. PMID:25177703

Total hip arthroplasty outcomes assessment using functional and radiographic scores to compare canine systems.

Science.gov (United States)

Iwata, D; Broun, H C; Black, A P; Preston, C A; Anderson, G I

2008-01-01

A retrospective multi-centre study was carried out in order to compare outcomes between cemented and uncemented total hip arthoplasties (THA). A quantitative orthopaedic outcome assessment scoring system was devised in order to relate functional outcome to a numerical score, to allow comparison between treatments and amongst centres. The system combined a radiographic score and a clinical score. Lower scores reflect better outcomes than higher scores. Consecutive cases of THA were included from two specialist practices between July 2002 and December 2005. The study included 46 THA patients (22 uncemented THA followed for 8.3 +/- 4.7M and 24 cemented THA for 26.0 +/- 15.7M) with a mean age of 4.4 +/- 3.3 years at surgery. Multi-variable linear and logistical regression analyses were performed with adjustments for age at surgery, surgeon, follow-up time, uni- versus bilateral disease, gender and body weight. The differences between treatment groups in terms of functional scores or total scores were not significant (p > 0.05). Radiographic scores were different between treatment groups. However, these scores were usually assessed within two months of surgery and proved unreliable predictors of functional outcome (p > 0.05). The findings reflect relatively short-term follow-up, especially for the uncemented group, and do not include clinician-derived measures, such as goniometry and thigh circumference. Longer-term follow-up for the radiographic assessments is essential. A prospective study including the clinician-derived outcomes needs to be performed in order to validate the outcome instrument in its modified form.

The relationship between supervisor support and registered nurse outcomes in nursing care units.

Science.gov (United States)

Hall, Debra S

2007-01-01

Workplace social support is a major characteristic related to the Job Demand-Control model of job stress. Organizational and managerial support have an effect on nurse satisfaction and burnout. The relationships between perceived supervisor support and measures of nurse occupation-related outcomes were investigated in 3 nursing units within an academic medical center. Nurses with greater levels of perceived supervisor support experienced more positive job outcomes and less negative outcomes, including less occupational stress, than nurses with less perceived supervisor support. Implications for refocusing the role of the nurse supervisor and its effect on multiple nursing occupation-related outcomes are discussed.

Utilizing Diffuse Reflection to Increase the Efficiency of Luminescent Solar Concentrators

Science.gov (United States)

Bowser, Seth; Weible, Seth; Solomon, Joel; Schrecengost, Jonathan; Wittmershaus, Bruce

A luminescent solar concentrator (LSC) consists of a high index solid plate containing a fluorescent material that converts sunlight into fluorescence. Utilizing total internal reflection, the LSC collects and concentrates the fluorescence at the plate's edges where it is converted into electricity via photovoltaic solar cells. The lower production costs of LSCs make them an attractive alternative to photovoltaic solar cells. To optimize an LSC's efficiency, a white diffusive surface (background) is positioned behind it. The background allows sunlight transmitted in the first pass to be reflected back through the LSC providing a second chance for absorption. Our research examines how the LSC's performance is affected by changing the distance between the white background and the LSC. An automated linear motion apparatus was engineered to precisely measure this distance and the LSC's electrical current, simultaneously. LSC plates, with and without the presence of fluorescent material and in an isolated environment, showed a maximum current at a distance greater than zero. Further experimentation has proved that the optimal distance results from the background's optical properties and how the reflected light enters the LSC. This material is based upon work supported by the National Science Foundation under Grant Number NSF-ECCS-1306157.

How might global health master deadly sins and strive for greater virtues?

Directory of Open Access Journals (Sweden)

Catherine Panter-Brick

2014-03-01

Full Text Available In the spirit of critical reflection, we examine how the field of global health might surmount current challenges and prioritize its ethical mandate, namely to achieve, for all people, equity in health. We use the parlance of mastering deadly sins and striving for greater virtues in an effort to review what is needed to transform global health action. Global health falls prey to four main temptations: coveting silo gains, lusting for technological solutions, leaving broad promises largely unfulfilled, and boasting of narrow successes. This necessitates a change of heart: to keep faith with the promise it made, global health requires a realignment of core values and a sharper focus on the primacy of relationships with the communities it serves. Based on the literature to date, we highlight six steps to re-orienting global health action. Articulating a coherent global health agenda will come from principled action, enacted through courage and prudence in decision-making to foster people-centered systems of care over the entire lifespan.

General method for eliminating wave reflection in 2D photonic crystal waveguides by introducing extra scatterers based on interference cancellation of waves

Science.gov (United States)

Huang, Hao; Ouyang, Zhengbiao

2018-01-01

We propose a general method for eliminating the reflection of waves in 2 dimensional photonic crystal waveguides (2D-PCWs), a kind of 2D material, by introducing extra scatterers inside the 2D-PCWs. The intrinsic reflection in 2D-PCWs is compensated by the backward-scattered waves from these scatterers, so that the overall reflection is greatly reduced and the insertion loss is improved accordingly. We first present the basic theory for the compensation method. Then, as a demonstration, we give four examples of extremely-low-reflection and high-transmission 90°bent 2D-PCWs created according to the method proposed. In the four examples, it is demonstrated by plane-wave expansion method and finite-difference time-domain method that the 90°bent 2D-PCWs can have high transmission ratio greater than 90% in a wide range of operating frequency, and the highest transmission ratio can be greater than 99.95% with a return loss higher than 43 dB, better than that in other typical 90°bent 2D-PCWs. With our method, the bent 2D-PCWs can be optimized to obtain high transmission ratio at different operating wavelengths. As a further application of this method, a waveguide-based optical bridge for light crossing is presented, showing an optimum return loss of 46.85 dB, transmission ratio of 99.95%, and isolation rates greater than 41.77 dB. The method proposed provides also a useful way for improving conventional waveguides made of cables, fibers, or metal walls in the optical, infrared, terahertz, and microwave bands.

The Greater Sekhukhune-CAPABILITY outreach project.

Science.gov (United States)

Gregersen, Nerine; Lampret, Julie; Lane, Tony; Christianson, Arnold

2013-07-01

The Greater Sekhukhune-CAPABILITY Outreach Project was undertaken in a rural district in Limpopo, South Africa, as part of the European Union-funded CAPABILITY programme to investigate approaches for capacity building for the translation of genetic knowledge into care and prevention of congenital disorders. Based on previous experience of a clinical genetic outreach programme in Limpopo, it aimed to initiate a district clinical genetic service in Greater Sekhukhune to gain knowledge and experience to assist in the implementation and development of medical genetic services in South Africa. Implementing the service in Greater Sekhukhune was impeded by a developing staff shortage in the province and pressure on the health service from the existing HIV/AIDS and TB epidemics. This situation underscores the need for health needs assessment for developing services for the care and prevention of congenital disorders in middle- and low-income countries. However, these impediments stimulated the pioneering of innovate ways to offer medical genetic services in these circumstances, including tele-teaching of nurses and doctors, using cellular phones to enhance clinical care and adapting and assessing the clinical utility of a laboratory test, QF-PCR, for use in the local circumstances.

Three-dimensional fusion of spaceborne and ground radar reflectivity data using a neural network-based approach

Science.gov (United States)

Kou, Leilei; Wang, Zhuihui; Xu, Fen

2018-03-01

The spaceborne precipitation radar onboard the Tropical Rainfall Measuring Mission satellite (TRMM PR) can provide good measurement of the vertical structure of reflectivity, while ground radar (GR) has a relatively high horizontal resolution and greater sensitivity. Fusion of TRMM PR and GR reflectivity data may maximize the advantages from both instruments. In this paper, TRMM PR and GR reflectivity data are fused using a neural network (NN)-based approach. The main steps included are: quality control of TRMM PR and GR reflectivity data; spatiotemporal matchup; GR calibration bias correction; conversion of TRMM PR data from Ku to S band; fusion of TRMM PR and GR reflectivity data with an NN method; interpolation of reflectivity data that are below PR's sensitivity; blind areas compensation with a distance weighting-based merging approach; combination of three types of data: data with the NN method, data below PR's sensitivity and data within compensated blind areas. During the NN fusion step, the TRMM PR data are taken as targets of the training NNs, and gridded GR data after horizontal downsampling at different heights are used as the input. The trained NNs are then used to obtain 3D high-resolution reflectivity from the original GR gridded data. After 3D fusion of the TRMM PR and GR reflectivity data, a more complete and finer-scale 3D radar reflectivity dataset incorporating characteristics from both the TRMM PR and GR observations can be obtained. The fused reflectivity data are evaluated based on a convective precipitation event through comparison with the high resolution TRMM PR and GR data with an interpolation algorithm.

Looking Back to Move Forward: First-Year Medical Students' Meta-Reflections on Their Narrative Portfolio Writings.

Science.gov (United States)

Cunningham, Hetty; Taylor, Delphine; Desai, Urmi A; Quiah, Samuel C; Kaplan, Benjamin; Fei, Lorraine; Catallozzi, Marina; Richards, Boyd; Balmer, Dorene F; Charon, Rita

2018-06-01

The day-to-day rigors of medical education often preclude learners from gaining a longitudinal perspective on who they are becoming. Furthermore, the current focus on competencies, coupled with concerning rates of trainee burnout and a decline in empathy, have fueled the search for pedagogic tools to foster students' reflective capacity. In response, many scholars have looked to the tradition of narrative medicine to foster "reflective spaces" wherein holistic professional identity construction can be supported. This article focuses on the rationale, content, and early analysis of the reflective space created by the narrative medicine-centered portfolio at the Columbia University Vagelos College of Physicians and Surgeons. In January 2015, the authors investigated learning outcomes derived from students' "Signature Reflections," end-of-semester meta-reflections on their previous portfolio work. The authors analyzed the Signature Reflections of 97 (of 132) first-year medical students using a constant comparative process. This iterative approach allowed researchers to identify themes within students' writings and interpret the data. The authors identified two overarching interpretive themes-recognition and grappling-and six subthemes. Recognition included comments about self-awareness and empathy. Grappling encompassed the subthemes of internal change, dichotomies, wonder and questioning, and anxiety. Based on the authors' analyses, the Signature Reflection seems to provide a structured framework that encourages students' reflective capacity and the construction of holistic professional identity. Other medical educators may adopt meta-reflection, within the reflective space of a writing portfolio, to encourage students' acquisition of a longitudinal perspective on who they are becoming and how they are constructing their professional identity.

Integrated Employee Occupational Health and Organizational-Level Registered Nurse Outcomes.

Science.gov (United States)

Mohr, David C; Schult, Tamara; Eaton, Jennifer Lipkowitz; Awosika, Ebi; McPhaul, Kathleen M

2016-05-01

The study examined organizational culture, structural supports, and employee health program integration influence on registered nurse (RN) outcomes. An organizational health survey, employee health clinical operations survey, employee attitudes survey, and administration data were collected. Multivariate regression models examined outcomes of sick leave, leave without pay, voluntary turnover, intention to leave, and organizational culture using 122 medical centers. Lower staffing ratios were associated with greater sick leave, higher turnover, and intention to leave. Safety climate was favorably associated with each of the five outcomes. Both onsite employee occupational health services and a robust health promotion program were associated with more positive organizational culture perceptions. Findings highlight the positive influence of integrating employee health and health promotion services on organizational health outcomes. Attention to promoting employee health may benefit organizations in multiple, synergistic ways.

Near zero reflection by nanostructured anti-reflection coating design for Si substrates

Science.gov (United States)

Al-Fandi, Mohamed; Makableh, Yahia F.; Khasawneh, Mohammad; Rabady, Rabi

2018-05-01

The nanostructure design of near zero reflection coating for Si substrates by using ZnO Nanoneedles (ZnONN) is performed and optimized for the visible spectral range. The design investigates the ZnONN tip to body ratio effect on the anti-reflection coating properties. Different tip to body ratios are used on Si substrates. Around zero reflection is achieved by the Nanoneedles structure design presented in this work, leading to minimal reflection losses from the Si surface. The current design evolves a solution to optical losses and surface contamination effects associated with Si solar cells.

Infrared reflection nebulae in Orion Molecular Cloud

International Nuclear Information System (INIS)

Pendleton, Y.; Werner, M.W.; Capps, R.; Lester, D.; Hawaii Univ., Honolulu; Texas Univ., Austin)

1986-01-01

New observations of Orion Molecular Cloud 2 have been made from 1 to 100 microns using the NASA Infrared Telescope Facility and the Kuiper Airborne Observatory. An extensive program of polarimetry, photometry, and spectrophotometry has shown that the extended emission regions associated with two of the previously known near-infrared sources, IRS 1 and IRS 4, are infrared reflection nebulae, and that the compact sources IRS 1 and IRS 4 are the main luminosity sources in the cloud. The constraints from the far-infrared observations and an analysis of the scattered light from the IRS 1 nebula show that OMC-2/IRS 1 can be characterized by L of 500 solar luminosities or less and T of roughly 1000 K. The near-infrared albedo of the grains in the IRS 1 nebula is greater than 0.08. 27 references

Editorial: Improving cataract outcomes through good postoperative care

Directory of Open Access Journals (Sweden)

Nick Astbury

2016-10-01

Full Text Available Cataract surgery is one of the most successful and frequently performed operations worldwide, and yet cataract remains the commonest cause of global blindness. This is in part due to the shortage and uneven distribution of trained personnel in some countries. More worryingly, a high rate of cataract blindness also reflects poor visual outcomes after surgery, as has been documented in many RAAB (rapid assessment of avoidable blindness studies.

Postgraduate Education to Support Organisation Change: A Reflection on Reflection

Science.gov (United States)

Stewart, Jim; Keegan, Anne; Stevens, Pam

2008-01-01

Purpose: This paper aims to explore how teaching and assessing reflective learning skills can support postgraduate practitioners studying organisational change and explores the challenges for tutors in assessing these journals. Design/methodology/approach: Assessment criteria were developed from the literature on reflective practice and…

Association of Gestational Weight Gain With Maternal and Infant Outcomes

DEFF Research Database (Denmark)

Goldstein, Rebecca F; Abell, Sally K; Ranasinha, Sanjeeva

2017-01-01

-11 kg for overweight women [BMI 25-29.9]; and 5-9 kg for obese women [BMI ≥30]) and maternal and infant outcomes. Data Sources and Study Selection: Search of EMBASE, Evidence-Based Medicine Reviews, MEDLINE, and MEDLINE In-Process between January 1, 1999, and February 7, 2017, for observational studies...... gestational weight gain less than IOM recommendations. Gestational weight gain greater than or less than guideline recommendations, compared with weight gain within recommended levels, was associated with higher risk of adverse maternal and infant outcomes....

Mobile Tracking Systems Using Meter Class Reflective Telescopes

Science.gov (United States)

Sturzenbecher, K.; Ehrhorn, B.

This paper is a discussion on the use of large reflective telescopes on mobile tracking systems with modern instrument control systems. Large optics can be defined as reflective telescopes with an aperture of at least 20 inches in diameter. New carbon composite construction techniques allow for larger, stronger, and lighter telescopes ranging from 240 pounds for a 20 inch, to 800 pounds for a 32 inch, making them ideal for mobile tracking systems. These telescopes have better light gathering capability and produce larger images with greater detail at a longer range than conventional refractive lenses. In a mobile configuration these systems provide the ability to move the observation platform to the optimal location anywhere in the world. Mounting and systems integration - We will discuss how large telescopes can be physically fit to the mobile tracking system and the integration with the tracking systems' digital control system. We will highlight the remote control capabilities. We will discuss special calibration techniques available in a modern instrument control system such as star calibration, calibration of sensors. Tracking Performance - We will discuss the impact of using large telescopes on the performance of the mobile tracking system. We will highlight the capabilities for auto-tracking and sidereal rate tracking in a mobile mount. Large optics performance - We will discuss the advantages of two-mirror Ritchey-Chrétien reflective optics which offer in-focus imaging across the spectrum, from visible to Long Wave Infrared. These zero expansion optics won't lose figure or focus during temperature changes. And the carbon composite telescope tube is thermally inert. The primary mirror is a modern lightweight "dish" mirror for low thermal mass and is center supported/self balancing. Applications - We will discuss Visible - IR Imaging requirements, Optical Rangefinders, and capabilities for special filters to increase resolution in difficult conditions such as

The associations among prior drinking consequences, subjective evaluations, and subsequent alcohol outcomes.

Science.gov (United States)

Zaso, Michelle J; Park, Aesoon; Kim, Jueun; Gellis, Les A; Kwon, Hoin; Maisto, Stephen A

2016-05-01

Although the many positive and negative psychosocial consequences of alcohol use are well documented, evidence of the association between prior drinking consequences and subsequent alcohol-related outcomes is mixed. Social learning theory highlights that cognitive appraisals of prior drinking consequences play a crucial intermediate role in the relation of prior drinking consequences with subsequent alcohol-related outcomes. This prospective study was designed to test the mediating effects of subjective evaluations (i.e., perceived valence and controllability) in the association of prior drinking consequences with change in binge drinking and drinking consequences over time. Participants were 171 college students (69% female, 74% White, M age = 18.95 years, SD = 1.35) who completed 2 online surveys, with an average interval of 68 days (SD = 10.22) between assessments. Path analyses of the data did not support mediational effects of perceived valence or controllability of prior drinking consequences on subsequent alcohol-related outcomes. Specifically, greater frequency of negative consequences was associated with lower perceived valence and controllability, and greater frequency of positive consequences was associated with lower perceived controllability of the experienced consequences. However, perceptions of valence and controllability were not in turn associated with subsequent binge drinking and drinking consequences. Instead, greater frequency of positive consequences was directly associated with greater subsequent frequency of binge drinking. Findings highlight the importance of prior positive consequences in the escalation of binge drinking over a short period of time, although this relation may not be accounted for by perceptions of valence and controllability of the prior drinking consequences. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

An anterior-to-posterior shift in midline cortical activity in schizophrenia during self-reflection.

Science.gov (United States)

Holt, Daphne J; Cassidy, Brittany S; Andrews-Hanna, Jessica R; Lee, Su Mei; Coombs, Garth; Goff, Donald C; Gabrieli, John D; Moran, Joseph M

2011-03-01

Deficits in social cognition, including impairments in self-awareness, contribute to the overall functional disability associated with schizophrenia. Studies in healthy subjects have shown that social cognitive functions, including self-reflection, rely on the medial prefrontal cortex (mPFC) and posterior cingulate gyrus, and these regions exhibit highly correlated activity during "resting" states. In this study, we tested the hypothesis that patients with schizophrenia show dysfunction of this network during self-reflection and that this abnormal activity is associated with changes in the strength of resting-state correlations between these regions. Activation during self-reflection and control tasks was measured with functional magnetic resonance imaging in 19 patients with schizophrenia and 20 demographically matched control subjects. In addition, the resting-state functional connectivity of midline cortical areas showing abnormal self-reflection-related activation in schizophrenia was measured. Compared with control subjects, the schizophrenia patients demonstrated lower activation of the right ventral mPFC and greater activation of the mid/posterior cingulate gyri bilaterally during self-reflection, relative to a control task. A similar pattern was seen during overall social reflection. In addition, functional connectivity between the portion of the left mid/posterior cingulate gyrus showing abnormally elevated activity during self-reflection in schizophrenia, and the dorsal anterior cingulate gyrus was lower in the schizophrenia patients compared with control subjects. Schizophrenia is associated with an anterior-to-posterior shift in introspection-related activation, as well as changes in functional connectivity, of the midline cortex. These findings provide support for the hypothesis that aberrant midline cortical function contributes to social cognitive impairment in schizophrenia. Copyright © 2011 Society of Biological Psychiatry. Published by Elsevier

Patient-reported outcome measures for chronic obstructive pulmonary disease : the exclusion of people with low literacy skills and learning disabilities

NARCIS (Netherlands)

Jahagirdar, D.; Kroll, T.; Ritchie, K.; Wyke, S.

2013-01-01

BACKGROUND: Patient-reported outcome measures (PROMs) are intended to reflect outcomes relevant to patients. They are increasingly used for healthcare quality improvement. To produce valid measures, patients should be involved in the development process but it is unclear whether this usually

Competency-Based Medical Education and the Ghost of Kuhn: Reflections on the Messy and Meaningful Work of Transformation.

Science.gov (United States)

Holmboe, Eric S

2018-03-01

The transition, if not transformation, to outcomes-based medical education likely represents a paradigm shift struggling to be realized. Paradigm shifts are messy and difficult but ultimately meaningful if done successfully. This struggle has engen dered tension and disagreements, with many of these disagreements cast as either-or polarities. There is little disagreement, however, that the health care system is not effectively achieving the triple aim for all patients. Much of the tension and polarity revolve around how more effectively to prepare students and residents to work in and help change a complex health care system.Competencies were an initial attempt to facilitate this shift by creating frameworks of essential abilities needed by physicians. However, implementation of competencies has proven to be difficult. Entrustable professional activities (EPAs) in undergraduate and graduate medical education and Milestones in graduate medical education are recent concepts being tried and studied as approaches to guide the shift to outcomes. Their primary purpose is to help facilitate implementation of an outcomes-based approach by creating shared mental models of the competencies, which in turn can help to improve curricula and assessment. Understanding whether and how EPAs and Milestones effectively facilitate the shift to outcomes has been and will continue to be an iterative and ongoing reflective process across the entire medical education community using lessons from implementation and complexity science. In this Invited Commentary, the author reflects on what got the community to this point and some sources of tension involved in the struggle to move to outcomes-based education.

Critical reflections on realist review: insights from customizing the methodology to the needs of participatory research assessment.

Science.gov (United States)

Jagosh, Justin; Pluye, Pierre; Wong, Geoff; Cargo, Margaret; Salsberg, Jon; Bush, Paula L; Herbert, Carol P; Green, Lawrence W; Greenhalgh, Trish; Macaulay, Ann C

2014-06-01

Realist review has increased in popularity as a methodology for complex intervention assessment. Our experience suggests that the process of designing a realist review requires its customization to areas under investigation. To elaborate on this idea, we first describe the logic underpinning realist review and then present critical reflections on our application experience, organized in seven areas. These are the following: (1) the challenge of identifying middle range theory; (2) addressing heterogeneity and lack of conceptual clarity; (3) the challenge of appraising the quality of complex evidence; (4) the relevance of capturing unintended outcomes; (5) understanding the process of context, mechanism, and outcome (CMO) configuring; (6) incorporating middle-range theory in the CMO configuration process; and (7) using middle range theory to advance the conceptualization of outcomes - both visible and seemingly 'hidden'. One conclusion from our experience is that the degree of heterogeneity of the evidence base will determine whether theory can drive the development of review protocols from the outset, or will follow only after an intense period of data immersion. We hope that presenting a critical reflection on customizing realist review will convey how the methodology can be tailored to the often complex and idiosyncratic features of health research, leading to innovative evidence syntheses. Copyright © 2013 John Wiley & Sons, Ltd.

Enhancing Decision-Making in STSE Education by Inducing Reflection and Self-Regulated Learning

Science.gov (United States)

Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

2017-02-01

Thoughtful decision-making to resolve socioscientific issues is central to science, technology, society, and environment (STSE) education. One approach for attaining this goal involves fostering students' decision-making processes. Thus, the present study explores whether the application of decision-making strategies, combined with reflections on the decision-making processes of others, enhances decision-making competence. In addition, this study examines whether this process is supported by elements of self-regulated learning, i.e., self-reflection regarding one's own performance and the setting of goals for subsequent tasks. A computer-based training program which involves the resolution of socioscientific issues related to sustainable development was developed in two versions: with and without elements of self-regulated learning. Its effects on decision-making competence were analyzed using a pre test-post test follow-up control-group design ( N = 242 high school students). Decision-making competence was assessed using an open-ended questionnaire that focused on three facets: consideration of advantages and disadvantages, metadecision aspects, and reflection on the decision-making processes of others. The findings suggest that students in both training groups incorporated aspects of metadecision into their statements more often than students in the control group. Furthermore, both training groups were more successful in reflecting on the decision-making processes of others. The students who received additional training in self-regulated learning showed greater benefits in terms of metadecision aspects and reflection, and these effects remained significant two months later. Overall, our findings demonstrate that the application of decision-making strategies, combined with reflections on the decision-making process and elements of self-regulated learning, is a fruitful approach in STSE education.

Sequential fitting-and-separating reflectance components for analytical bidirectional reflectance distribution function estimation.

Science.gov (United States)

Lee, Yu; Yu, Chanki; Lee, Sang Wook

2018-01-10

We present a sequential fitting-and-separating algorithm for surface reflectance components that separates individual dominant reflectance components and simultaneously estimates the corresponding bidirectional reflectance distribution function (BRDF) parameters from the separated reflectance values. We tackle the estimation of a Lafortune BRDF model, which combines a nonLambertian diffuse reflection and multiple specular reflectance components with a different specular lobe. Our proposed method infers the appropriate number of BRDF lobes and their parameters by separating and estimating each of the reflectance components using an interval analysis-based branch-and-bound method in conjunction with iterative K-ordered scale estimation. The focus of this paper is the estimation of the Lafortune BRDF model. Nevertheless, our proposed method can be applied to other analytical BRDF models such as the Cook-Torrance and Ward models. Experiments were carried out to validate the proposed method using isotropic materials from the Mitsubishi Electric Research Laboratories-Massachusetts Institute of Technology (MERL-MIT) BRDF database, and the results show that our method is superior to a conventional minimization algorithm.

Sex differences in sport-related concussion long-term outcomes.

Science.gov (United States)

Covassin, Tracey; Savage, Jennifer L; Bretzin, Abigail C; Fox, Meghan E

2017-09-18

Approximately 1.6 to 3.8 million recreational and sports-related concussions (SRC) occur each year in the Unites States. Research suggest that female athletes are at a greater risk for a SRC compared to male athletes competing in comparable sports (i.e., soccer, basketball). Moreover, female athletes have reported more total symptoms and greater neurocognitive impairments following a SRC. Female athletes have been found to report greater symptom provocation as measured by the Vestibular/Ocular Motor Screening (VOMS), and increased brain activation compared to males. There is a scarcity of research on long-term effects of SRC in male and female athletes. Therefore, the aim of this review article is to summarize the existing literature on sex differences in acute and sub-acute SRC outcomes. Copyright © 2017. Published by Elsevier B.V.

Effects of dual pathology on cognitive outcome following left anterior temporal lobectomy for treatment of epilepsy.

Science.gov (United States)

Prayson, B E; Prayson, R A; Kubu, C S; Bingaman, W; Najm, I M; Busch, R M

2013-09-01

The objective of this retrospective study was to determine if dual pathology [DUAL - focal cortical dysplasia (FCD) and mesial temporal sclerosis (MTS)] in patients with left temporal lobe epilepsy is associated with greater risk for cognitive decline following temporal lobectomy than single pathology (MTS only). Sixty-three adults (Mage=36.5years, female: 52.4%) who underwent left anterior temporal lobectomy for treatment of epilepsy (MTS=28; DUAL=35) completed preoperative and postoperative neuropsychological evaluations. The base rate of dual pathology was 55.5%. Repeated measures ANOVAs yielded significant 2-way interactions (group×time) on most measures of language and memory with generally moderate effect sizes. Specifically, patients with MTS only demonstrated postoperative declines, while those with dual pathology remained unchanged or improved. Results suggest that dual pathology may be associated with better cognitive outcome following epilepsy surgery than MTS alone, possibly reflecting limited functionality of the resected tissue or intrahemispheric reorganization of function in the context of a developmental lesion. Copyright © 2013 Elsevier Inc. All rights reserved.

The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety.

Science.gov (United States)

Brody, Stuart; Krüger, Tillmann H C

2006-03-01

Research indicates that prolactin increases following orgasm are involved in a feedback loop that serves to decrease arousal through inhibitory central dopaminergic and probably peripheral processes. The magnitude of post-orgasmic prolactin increase is thus a neurohormonal index of sexual satiety. Using data from three studies of men and women engaging in masturbation or penile-vaginal intercourse to orgasm in the laboratory, we report that for both sexes (adjusted for prolactin changes in a non-sexual control condition), the magnitude of prolactin increase following intercourse is 400% greater than that following masturbation. The results are interpreted as an indication of intercourse being more physiologically satisfying than masturbation, and discussed in light of prior research reporting greater physiological and psychological benefits associated with coitus than with any other sexual activities.

Hygrothermal degradation of (3-glycidoxypropyl)trimethoxysilane films studied by neutron and X-ray reflectivity and attenuated total reflection infrared spectroscopy

International Nuclear Information System (INIS)

Tallant, David Robert; Garcia, Manuel Joseph; Majewski, Jaroslaw; Kent, Michael Stuart; Yim, Hyun

2005-01-01

Thin films of organosilanes have great technological importance in the areas of adhesion promotion, durability, and corrosion resistance. However, it is well-known that water can degrade organosilane films, particularly at elevated temperatures. In this work, X-ray and neutron reflectivity (XR and NR) were combined with attenuated total reflection infrared (ATR-IR) spectroscopy to study the chemical and structural changes within thin films of (3-glycidoxypropyl)trimethoxysilane (GPS) after exposure for various periods of time to air saturated with either D 2 O or H 2 O at 80 C. For NR and XR, ultrathin (∼100 (angstrom)) films were prepared by spin-coating. Both D 2 O and H 2 O provide neutron scattering contrast with GPS. Variations in the neutron scattering length density (SLD) profiles (a function of mass density and atomic composition) with conditioning time were measured after drying the samples out and also swelled with H 2 O or D 2 O vapor at room temperature. For samples that were dried out prior to measurement, little or no change was observed for H 2 O conditioning up to 3.5 days, but large changes were observed after 30 days of conditioning. The range of conditioning time for this structural change was narrowed to between 4 and 10 days with XR. The SLD profiles indicated that the top portion of the GPS film was transformed into a thick low-density layer after conditioning, but the bottom portion showed little structural change. A previous NR study of as-prepared GPS films involving swelling with deuterated nitrobenzene showed that the central portion of the film has much lower cross-link density than the region nearest the substrate. The present data show that the central portion also swells to a much greater extent with water and hydrolyzes more rapidly. The chemical degradation mechanism was identified by IR as hydrolysis of siloxane bonds. For ATR-IR, GPS films were prepared by dip-coating, which resulted in a greater and more variable thickness than

Reflection and Reflective Practice Discourses in Coaching: A Critical Analysis

Science.gov (United States)

Cushion, Christopher J.

2018-01-01

Reflection and reflective practice is seen as an established part of coaching and coach education practice. It has become a "taken-for-granted" part of coaching that is accepted enthusiastically and unquestioningly, and is assumed to be "good" for coaching and coaches. Drawing on sociological concepts, a primarily Foucauldian…

The emotional challenges of conducting in-depth research into significant health issues in health geography: reflections on emotional labour, fieldwork and life course.

Science.gov (United States)

McGarrol, Sarah

2017-12-01

Emotions are increasingly being recognised and integrated into human geography and it has been highlighted that focusing on the 'interrelatedness' of the research process is crucial. By contextualising fieldwork within the life course of the researcher, greater acknowledgement of the 'emotional labour' involved in fieldwork can be highlighted. The author reflects on the 'emotional geographies' of conducting PhD research into significant health issues with participants who had recently suffered a heart attack in Fife, Scotland. This paper reveals emotions involved in this kind of research, drawing on perspectives from participants as well as the researcher. The author also draws attention to, and reflects on, the lack of engagement with researcher's emotional labour within formal academic structures, such as research training and ethics application processes. Reflecting on fieldwork experiences from a distance, the author discusses the influence and impact of her emotional experiences of fieldwork. This paper contributes to work concerned with emotions and fieldwork in geography and asserts that greater importance and value needs to be given to this type of emotion work as embedded and situated within researchers' life courses.

Attachment and parental reflective functioning features in ADHD: Enhancing the knowledge on parenting characteristics

Directory of Open Access Journals (Sweden)

Clarissa eCavallina

2015-09-01

Full Text Available Attention-deficit/hyperactivity disorder (ADHD is a disorder characterized by a chronic, pervasive, and developmentally inappropriate level of impulsivity, attention and concentration. It is associated with adverse academic and social functions and stress to families. Studies provide evidence that family variables are correlated with this disorder and that parenting styles play an important role in its complexity. However, a thorough investigation of the impact of parental affective and relational aspects on the ADHD child’s areas of functioning is still needed. We suggest investigating parenting characteristics to a greater extent by adopting an attachment perspective with a focus on parental reflective functioning as it pertains to the child’s ADHD clinical condition. In future research, parents’ attachment and the parental reflective functioning should be taken into account.

Sex-related differences in outcomes after hallux valgus surgery.

Science.gov (United States)

Choi, Gi Won; Kim, Hak Jun; Kim, Tae Wan; Lee, Ji Wun; Park, Sung Bum; Kim, Jin Kak

2015-03-01

With differences between the sexes in foot bone anatomy and ligamentous laxity, there is the possibility that the results of hallux valgus surgery may also differ between the sexes. We aimed to compare the results of hallux valgus surgery between the sexes. The authors retrospectively reviewed 60 males (66 feet) and 70 females (82 feet) who underwent distal or proximal chevron osteotomy for the treatment of hallux valgus deformity between June 2005 and December 2011. We compared the clinical and radiologic outcomes between the sexes. There were no statistically significant differences in demographics between the sexes. The mean American Orthopedic Foot and Ankle Society score, visual analogue scale for pain, and patient satisfaction at the last follow-up did not differ significantly between the sexes. The mean preoperative hallux valgus angle (HVA) and inter-metatarsal angle (IMA) were not significantly different between the sexes. At the last follow-up, the mean HVA was significantly greater in females (p=0.003) than in males; mean IMA was not significantly different between the sexes. The mean correction of HVA in males was significantly greater than that in females (p=0.014). There were no significant differences between the sexes regarding clinical outcomes after distal and proximal chevron osteotomy. However, male patients achieved greater correction of HVA than female patients. There is a possibility that sexual dimorphism of the foot may affect postoperative HVA.

Obtaining local reflectivity at two-way travel time by filtering acoustic reflection data

NARCIS (Netherlands)

Slob, E.C.; Zhang, L.; Wapenaar, C.P.A.; Mihai Popovici, A.; Fomel, S.

2017-01-01

A modified implementation of Marchenko redatuming leads to a filter that removes internal multiples from reflection data. It produces local reflectivity at two-way travel time. The method creates new primary reflections resulting from emitted events that eliminate internal multiples. We call these

Predicting the In-Hospital Responsiveness to Treatment of Alcoholics. Social Factors as Predictors of Outcome. Brain Damage as a Factor in Treatment Outcome of Chronic Alcoholic Patients.

Science.gov (United States)

Mascia, George V.; And Others

The authors attempt to locate predictor variables associated with the outcome of alcoholic treatment programs. Muscia's study focuses on the predictive potential of: (1) response to a GSR conditioning procedure; (2) several personality variables; and (3) age and IQ measures. Nine variables, reflecting diverse perspectives, were selected as a basis…

Reflective Practices for Teacher Education

Directory of Open Access Journals (Sweden)

Paulus Kuswandono

2017-01-01

Full Text Available Studies on reflective practice in teacher education are increasingly getting more attention at least in the last 2 decades. This article discusses concepts of reflection and how it is implemented in educating pre-service teachers on their early stage of professional learning. The purposes of doing the reflection for pre-service teachers are not only for illuminating their professional learning experiences, but also to critically reflect their vocation as teachers, including the values which may be dictated to them through rigid regulations. Reflection in teacher education is crucial as it connects well with learning in that learners use reflection to exercise their mind and to evaluate their learning experiences. Besides, this article also highlights some perceived difficulties to implement reflective practice, as well as ways how to promote reflection.   DOI: https://doi.org/10.24071/llt.2012.150102

Catheter based mid-infrared reflectance and reflectance generated absorption spectroscopy

Science.gov (United States)

Holman, Hoi-Ying N

2013-10-29

A method of characterizing conditions in a tissue, by (a) providing a catheter that has a light source that emits light in selected wavenumbers within the range of mid-IR spectrum; (b) directing the light from the catheter to an area of tissue at a location inside a blood vessel of a subject; (c) collecting light reflected from the location and generating a reflectance spectra; and (d) comparing the reflectance spectra to a reference spectra of normal tissue, whereby a location having an increased number of absorbance peaks at said selected wavenumbers indicates a tissue inside the blood vessel containing a physiological marker for atherosclerosis.

Logged peat swamp forest supports greater macrofungal biodiversity than large-scale oil palm plantations and smallholdings.

Science.gov (United States)

Shuhada, Siti Noor; Salim, Sabiha; Nobilly, Frisco; Zubaid, Akbar; Azhar, Badrul

2017-09-01

Intensive land expansion of commercial oil palm agricultural lands results in reducing the size of peat swamp forests, particularly in Southeast Asia. The effect of this land conversion on macrofungal biodiversity is, however, understudied. We quantified macrofungal biodiversity by identifying mushroom sporocarps throughout four different habitats; logged peat swamp forest, large-scale oil palm plantation, monoculture, and polyculture smallholdings. We recorded a total of 757 clusters of macrofungi belonging to 127 morphospecies and found that substrates for growing macrofungi were abundant in peat swamp forest; hence, morphospecies richness and macrofungal clusters were significantly greater in logged peat swamp forest than converted oil palm agriculture lands. Environmental factors that influence macrofungi in logged peat swamp forests such as air temperature, humidity, wind speed, soil pH, and soil moisture were different from those in oil palm plantations and smallholdings. We conclude that peat swamp forests are irreplaceable with respect to macrofungal biodiversity. They host much greater macrofungal biodiversity than any of the oil palm agricultural lands. It is imperative that further expansion of oil palm plantation into remaining peat swamp forests should be prohibited in palm oil producing countries. These results imply that macrofungal distribution reflects changes in microclimate between habitats and reduced macrofungal biodiversity may adversely affect decomposition in human-modified landscapes.

Studies of the Reflection, Refraction and Internal Reflection of Light

Science.gov (United States)

Lanchester, P. C.

2014-01-01

An inexpensive apparatus and associated experiments are described for studying the basic laws of reflection and refraction of light at an air-glass interface, and multiple internal reflections within a glass block. In order to motivate students and encourage their active participation, a novel technique is described for determining the refractive…

Neurologic Outcomes in Very Preterm Infants Undergoing Surgery.

LENUS (Irish Health Repository)

2012-01-31

OBJECTIVE: To investigate the relationship between surgery in very preterm infants and brain structure at term equivalent and 2-year neurodevelopmental outcome. STUDY DESIGN: A total of 227 infants born at <30 weeks gestation or at a birth weight of <1250 g were prospectively enrolled into a longitudinal observational cohort for magnetic resonance imaging and developmental follow-up. The infants were categorized retrospectively into either a nonsurgical group (n=178) or a surgical group (n=30). Nineteen infants were excluded because of incomplete or unsuitable data. The surgical and nonsurgical groups were compared in terms of clinical demographic data, white matter injury, and brain volume at term. Neurodevelopmental outcome was assessed at age 2 years. RESULTS: Compared with the nonsurgical group, the infants in the surgical group were smaller and more growth-restricted at birth, received more respiratory support and oxygen therapy, and had longer hospital stays. They also had smaller brain volumes, particularly smaller deep nuclear gray matter volumes. Infants who underwent bowel surgery had greater white matter injury. Mental Developmental Index scores were lower in the surgical group, whereas Psychomotor Developmental Index scores did not differ between the groups. The Mental Developmental Index difference became nonsignificant after adjustment for confounding variables. CONCLUSION: Preterm infants exposed to surgery and anesthesia had greater white matter injury and smaller total brain volumes, particularly smaller deep nuclear gray matter volumes. Surgical exposure in the preterm infant should alert the clinician to an increased risk for adverse cognitive outcome.

Authentic leadership and nurse-assessed adverse patient outcomes.

Science.gov (United States)

Wong, Carol A; Giallonardo, Lisa M

2013-07-01

Our purpose was to test a model examining relationships among authentic leadership, nurses' trust in their manager, areas of work life and nurse-assessed adverse patient outcomes. Although several work environment factors have been cited as critical to patient outcomes, studies linking nursing leadership styles with patient outcomes are limited suggesting the need for additional research to investigate the mechanisms by which leadership may influence patient outcomes. Secondary analysis of data collected in a cross-sectional survey of 280 (48% response rate) registered nurses working in acute care hospitals in Ontario was conducted using structural equation modelling. The final model fit the data acceptably (χ(2) = 1.30, df = 2, P = 0.52, IFI = 0.99, CFI = 1.00, RMSEA = 0.00). Authentic leadership was significantly associated with decreased adverse patient outcomes through trust in the manager and areas of work life. The findings suggest that nurses who see their managers as demonstrating high levels of authentic leadership report increased trust, greater congruence in the areas of work life and lower frequencies of adverse patient outcomes. Managers who emphasize transparency, balanced processing, self-awareness and high ethical standards in their interactions with nurses may contribute to safer work environments for patients and nurses. © 2013 John Wiley & Sons Ltd.

Circulating AMH reflects ovarian morphology by magnetic resonance imaging and 3D ultrasound in 121 healthy girls

DEFF Research Database (Denmark)

Hagen, Casper P; Mouritsen, Annette; Mieritz, Mikkel G

2015-01-01

aimed to evaluate whether serum levels of AMH reflects ovarian morphology in healthy girls. DESIGN AND SETTING: This was a population-based cohort study involving the general community. PARTICIPANTS: Included in the study were 121 healthy girls 9.8-14.7 years of age. MAIN OUTCOME MEASURES: Clinical...... volume, follicles ≥1 mm. Circulating levels of AMH, inhibin B, estradiol, FSH, and LH were assessed by immunoassays; T and androstenedione were assessed by liquid chromatography-tandem mass spectrometry. RESULTS: AMH reflected the number of small (MRI 2-3 mm) and medium (4-6 mm) follicles (Pearson's Rho...

Technical concept for a greater-confinement-disposal test facility

International Nuclear Information System (INIS)

Hunter, P.H.

1982-01-01

Greater confinement disposal (GCO) has been defined by the National Low-Level Waste Program as the disposal of low-level waste in such a manner as to provide greater containment of radiation, reduce potential for migration or dispersion or radionuclides, and provide greater protection from inadvertent human and biological intrusions in order to protect the public health and safety. This paper discusses: the need for GCD; definition of GCD; advantages and disadvantages of GCD; relative dose impacts of GCD versus shallow land disposal; types of waste compatible with GCD; objectives of GCD borehole demonstration test; engineering and technical issues; and factors affecting performance of the greater confinement disposal facility

Self-rumination, self-reflection, and depression: self-rumination counteracts the adaptive effect of self-reflection.

Science.gov (United States)

Takano, Keisuke; Tanno, Yoshihiko

2009-03-01

Self-focused attention has adaptive and maladaptive aspects: self-reflection and self-rumination [Trapnell, P. D., & Campbell, J. D. (1999). Private self-consciousness and the Five-Factor Model of personality: distinguishing rumination from reflection. Journal of Personality and Social Psychology, 76, 284-304]. Although reflection is thought to be associated with problem solving and the promotion of mental health, previous researches have shown that reflection does not always have an adaptive effect on depression. Authors have examined the causes behind this inconsistency by modeling the relationships among self-reflection, self-rumination, and depression. One hundred and eleven undergraduates (91 men and 20 women) participated in a two-time point assessment with a 3-week interval. Statistical analysis with structural equation modeling showed that self-reflection significantly predicted self-rumination, whereas self-rumination did not predict self-reflection. With regard to depression, self-reflection was associated with a lower level of depression; self-rumination, with a higher level of depression. The total effect of self-reflection on depression was almost zero. This result indicates that self-reflection per se has an adaptive effect, which is canceled out by the maladaptive effect of self-rumination, because reflectors are likely to ruminate and reflect simultaneously.

The challenge of diagnosing seborrheic keratosis by reflectance confocal microscopy.

Science.gov (United States)

Guo, A; Chen, J; Yang, C; Ding, Y; Zeng, Q; Tan, L

2018-05-24

Seborrheic keratosis (SK) is one of the most common skin tumors seen by dermatologists. It should be differentiated with many diseases, especially skin tumors. Reflectance confocal microscopy (RCM) has been applied for evaluation of SK. There are a few studies that describe the RCM of SK. The aim of the study was to find the challenge of diagnosing seborrheic keratosis by reflectance confocal microscopy. A total of 390 patients with a clinical suspicious diagnosis of seborrheic keratosis were enrolled in this study, and lesions from each patient were imaged with RCM. Thirty-seven of these patients performed a biopsy in order to be given a histological diagnosis. We retrospectively analyzed the outcomes of RCM diagnosis and histological diagnosis, and then found the RCM characteristics of biopsy-proven lesions. According to RCM images, 258 of 390 (66.2%) patients were diagnosed with SK, 97 of 390 (24.9%) patients could not be diagnosed by the dermatologist according to RCM. Of all 37 biopsied lesions, 23 were SK, 6 were actinic keratosis, 2 were basal cell carcinoma, and 2 were squamous cell carcinoma. It is challenge to diagnose seborrheic keratosis by reflectance confocal microscopy. It may due to the variable clinical and RCM appearances of SK, and limited depth of RCM. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PTSD Psychotherapy Outcome Predicted by Brain Activation During Emotional Reactivity and Regulation.

Science.gov (United States)

Fonzo, Gregory A; Goodkind, Madeleine S; Oathes, Desmond J; Zaiko, Yevgeniya V; Harvey, Meredith; Peng, Kathy K; Weiss, M Elizabeth; Thompson, Allison L; Zack, Sanno E; Lindley, Steven E; Arnow, Bruce A; Jo, Booil; Gross, James J; Rothbaum, Barbara O; Etkin, Amit

2017-12-01

Exposure therapy is an effective treatment for posttraumatic stress disorder (PTSD), but many patients do not respond. Brain functions governing treatment outcome are not well characterized. The authors examined brain systems relevant to emotional reactivity and regulation, constructs that are thought to be central to PTSD and exposure therapy effects, to identify the functional traits of individuals most likely to benefit from treatment. Individuals with PTSD underwent functional MRI (fMRI) while completing three tasks assessing emotional reactivity and regulation. Participants were then randomly assigned to immediate prolonged exposure treatment (N=36) or a waiting list condition (N=30). A random subset of the prolonged exposure group (N=17) underwent single-pulse transcranial magnetic stimulation (TMS) concurrent with fMRI to examine whether predictive activation patterns reflect causal influence within circuits. Linear mixed-effects modeling in line with the intent-to-treat principle was used to examine how baseline brain function moderated the effect of treatment on PTSD symptoms. At baseline, individuals with larger treatment-related symptom reductions (compared with the waiting list condition) demonstrated 1) greater dorsal prefrontal activation and 2) less left amygdala activation, both during emotion reactivity; 3) better inhibition of the left amygdala induced by single TMS pulses to the right dorsolateral prefrontal cortex; and 4) greater ventromedial prefrontal/ventral striatal activation during emotional conflict regulation. Reappraisal-related activation was not a significant moderator of the treatment effect. Capacity to benefit from prolonged exposure in PTSD is gated by the degree to which prefrontal resources are spontaneously engaged when superficially processing threat and adaptively mitigating emotional interference, but not when deliberately reducing negative emotionality.

Enhancing medical students' reflectivity in mentoring groups for professional development - a qualitative analysis.

Science.gov (United States)

Lutz, Gabriele; Pankoke, Nina; Goldblatt, Hadass; Hofmann, Marzellus; Zupanic, Michaela

2017-07-14

Professional competence is important in delivering high quality patient care, and it can be enhanced by reflection and reflective discourse e.g. in mentoring groups. However, students are often reluctant though to engage in this discourse. A group mentoring program involving all preclinical students as well as faculty members and co-mentoring clinical students was initiated at Witten-Herdecke University. This study explores both the attitudes of those students towards such a program and factors that might hinder or enhance how students engage in reflective discourse. A qualitative design was applied using semi-structured focus group interviews with preclinical students and semi-structured individual interviews with mentors and co-mentors. The interview data were analyzed using thematic content analysis. Students' attitudes towards reflective discourse on professional challenges were diverse. Some students valued the new program and named positive outcomes regarding several features of professional development. Enriching experiences were described. Others expressed aversive attitudes. Three reasons for these were given: unclear goals and benefits, interpersonal problems within the groups hindering development and intrapersonal issues such as insecurity and traditional views of medical education. Participants mentioned several program setup factors that could enhance how students engage in such groups: explaining the program thoroughly, setting expectations and integrating the reflective discourse in a meaningful way into the curriculum, obliging participation without coercion, developing a sense of security, trust and interest in each other within the groups, randomizing group composition and facilitating group moderators as positive peer and faculty role models and as learning group members. A well-designed and empathetic setup of group mentoring programs can help raise openness towards engaging in meaningful reflective discourse. Reflection on and communication of

Born reflection kernel analysis and wave-equation reflection traveltime inversion in elastic media

KAUST Repository

Wang, Tengfei

2017-08-17

Elastic reflection waveform inversion (ERWI) utilize the reflections to update the low and intermediate wavenumbers in the deeper part of model. However, ERWI suffers from the cycle-skipping problem due to the objective function of waveform residual. Since traveltime information relates to the background model more linearly, we use the traveltime residuals as objective function to update background velocity model using wave equation reflected traveltime inversion (WERTI). The reflection kernel analysis shows that mode decomposition can suppress the artifacts in gradient calculation. We design a two-step inversion strategy, in which PP reflections are firstly used to invert P wave velocity (Vp), followed by S wave velocity (Vs) inversion with PS reflections. P/S separation of multi-component seismograms and spatial wave mode decomposition can reduce the nonlinearity of inversion effectively by selecting suitable P or S wave subsets for hierarchical inversion. Numerical example of Sigsbee2A model validates the effectiveness of the algorithms and strategies for elastic WERTI (E-WERTI).

Principles of neutron reflection

International Nuclear Information System (INIS)

Felcher, G.P.

1988-08-01

Neutron reflection is perhaps the most developed branch of slow neutrons optics, which in itself is a direct consequence of the undulatory nature of the neutron. After reviewing the basic types of interactions (nuclear and magnetic) between neutrons and matter, the formalism is introduced to calculate the reflectivity from a sample composed of stacked flat layers and, inversely, to calculate the stacking from reflectivity measurements. Finally, a brief survey of the applications of neutron reflection is given, both in technology and in fundamental research. 32 refs., 6 figs

Storage array reflection considerations

International Nuclear Information System (INIS)

Haire, M.J.; Jordan, W.C.; Taylor, R.G.

1997-01-01

The assumptions used for reflection conditions of single containers are fairly well established and consistently applied throughout the industry in nuclear criticality safety evaluations. Containers are usually considered to be either fully water-reflected (i.e. surrounded by 6 to 12 in. of water) for safety calculations or reflected by 1 in. of water for nominal (structural material and air) conditions. Tables and figures are usually available for performing comparative evaluations of containers under various loading conditions. Reflection considerations used for evaluating the safety of storage arrays of fissile material are not as well established

Adverse outcome pathways (AOPs) to enhance EDC ...

Science.gov (United States)

Screening and testing for endocrine active chemicals was mandated under 1996 amendments to the Safe Drinking Water Act and Food Quality Protection Act. Efficiencies can be gained in the endocrine disruptor screening program by using available biological and toxicological knowledge to facilitate greater use of high throughput screening data and other data sources to inform endocrine disruptor assessments. Likewise, existing knowledge, when properly organized, can help aid interpretation of test results. The adverse outcome pathway (AOP) framework, which organizes information concerning measureable changes that link initial biological interactions with a chemical to adverse effects that are meaningful to risk assessment and management, can aid this process. This presentation outlines the ways in which the AOP framework has already been employed to support EDSP and how it may further enhance endocrine disruptor assessments in the future. Screening and testing for endocrine active chemicals was mandated under 1996 amendments to the Safe Drinking Water Act and Food Quality Protection Act. Efficiencies can be gained in the endocrine disruptor screening program by using available biological and toxicological knowledge to facilitate greater use of high throughput screening data and other data sources to inform endocrine disruptor assessments. Likewise, existing knowledge, when properly organized, can help aid interpretation of test results. The adverse outcome pathway

CO, CS, and HCN in a clustering of reflection nebulae in Monoceros

International Nuclear Information System (INIS)

Kutner, M.L.; Tucker, K.D.

1975-01-01

Carbon monoxide line emission at lambda=2.6 mm has been observed over an area of approx.3 1/2degreetimes3 1/2degree in L1646, a diffuse dust cloud containing a grouping of reflection nebulae. The H 2 mass is estimated from the CO observations to be >3.2times10 4 M/sub sun/. Five CO emission peaks are observed, each apparently associated with at least one reflection nebula, with the strongest peak at α (1950) =6)05)20), delta (1950) =-6degree22'30''. Around this position, extended (10'times10') emission is observed from HCN and CS, suggesting a core with H 2 density approximately-less-than8times10 4 cm -3 . This core appears to be rotating with Ωgreater than or equal to7.4times10 -14 s -1 . There is also evidence for self-absorption in the CO line in this direction, suggestive of a collapsing cloud. (auth)

Clinicians' and researchers' perspectives on establishing and implementing core outcomes in haemodialysis: semistructured interview study.

Science.gov (United States)

Tong, Allison; Crowe, Sally; Gill, John S; Harris, Tess; Hemmelgarn, Brenda R; Manns, Braden; Pecoits-Filho, Roberto; Tugwell, Peter; van Biesen, Wim; Wang, Angela Yee Moon; Wheeler, David C; Winkelmayer, Wolfgang C; Gutman, Talia; Ju, Angela; O'Lone, Emma; Sautenet, Benedicte; Viecelli, Andrea; Craig, Jonathan C

2018-04-20

To describe the perspectives of clinicians and researchers on identifying, establishing and implementing core outcomes in haemodialysis and their expected impact. Face-to-face, semistructured interviews; thematic analysis. Twenty-seven centres across nine countries. Fifty-eight nephrologists (42 (72%) who were also triallists). We identified six themes: reflecting direct patient relevance and impact (survival as the primary goal of dialysis, enabling well-being and functioning, severe consequences of comorbidities and complications, indicators of treatment success, universal relevance, stakeholder consensus); amenable and responsive to interventions (realistic and possible to intervene on, differentiating between treatments); reflective of economic burden on healthcare; feasibility of implementation (clarity and consistency in definition, easily measurable, requiring minimal resources, creating a cultural shift, aversion to intensifying bureaucracy, allowing justifiable exceptions); authoritative inducement and directive (endorsement for legitimacy, necessity of buy-in from dialysis providers, incentivising uptake); instituting patient-centredness (explicitly addressing patient-important outcomes, reciprocating trial participation, improving comparability of interventions for decision-making, driving quality improvement and compelling a focus on quality of life). Nephrologists emphasised that core outcomes should be relevant to patients, amenable to change, feasible to implement and supported by stakeholder organisations. They expected core outcomes would improve patient-centred care and outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Adiposity and psychosocial outcomes at ages 30 and 35.

Science.gov (United States)

McLeod, Geraldine F H; Fergusson, David M; John Horwood, L; Carter, Frances A

2016-02-01

To examine associations between adiposity and adult psychosocial outcomes (depressive symptoms, life satisfaction, self-esteem, household income, personal income, savings/investments) in a New Zealand birth cohort, by gender. Adiposity was assessed using Body Mass Index scores classified on a 3-point scale of BMI: depressive symptoms, life satisfaction, equivalized household income and savings/investments) remaining statistically significant (p < 0.05). In contrast, for males there was a significant (p = 0.008) positive association between adiposity and higher personal net weekly income after covariate adjustment. The findings suggest evidence of gender differences in the associations between adiposity and psychosocial outcomes. For females, there were small but pervasive tendencies for increasing adiposity to be related to more adverse mental health, psychological well-being and economic outcomes; whereas for males adiposity was either unrelated to these outcomes, or in the case of personal income, associated with greater economic advantage. The implications of these findings are discussed.

Variability in the Initial Costs of Care and One-Year Outcomes of Observation Services

Directory of Open Access Journals (Sweden)

Abbass, Ibrahim

2015-05-01

Full Text Available Introduction: The use of observation units (OUs following emergency departments (ED visits as a model of care has increased exponentially in the last decade. About one-third of U.S. hospitals now have OUs within their facilities. While their use is associated with lower costs and comparable level of care compared to inpatient units, there is a wide variation in OUs characteristics and operational procedures. The objective of this research was to explore the variability in the initial costs of care of placing patients with non-specific chest pain in observation units (OUs and the one-year outcomes. Methods: The author retrospectively investigated medical insurance claims of 22,962 privately insured patients (2009-2011 admitted to 41 OUs. Outcomes included the one-year chest pain/cardiovascular related costs and primary and secondary outcomes. Primary outcomes included myocardial infarction, congestive heart failure, stroke or cardiac arrest, while secondary outcomes included revascularization procedures, ED revisits for angina pectoris or chest pain and hospitalization due to cardiovascular diseases. The author aggregated the adjusted costs and prevalence rates of outcomes for patients over OUs, and computed the weighted coefficients of variation (WCV to compare variations across OUs. Results: There was minimal variability in the initial costs of care (WCV=2.2%, while the author noticed greater variability in the outcomes. Greater variability were associated with the adjusted cardiovascular-related costs of medical services (WCV=17.6% followed by the adjusted prevalence odds ratio of patients experiencing primary outcomes (WCV=16.3% and secondary outcomes (WCV=10%. Conclusion: Higher variability in the outcomes suggests the need for more standardization of the observation services for chest pain patients. [West J Emerg Med. 2015;16(3:395–400.

Relationship between maternal hemoglobin and perinatal outcome

International Nuclear Information System (INIS)

Bakhtiar, U.J.; Khan, Y.; Nisar, R.

2007-01-01

To Study the Relationship between Maternal Hemoglobin and Perinatal outcome in a cohort of 860 pregnant women and to highlight the importance of antenatal care regarding maternal health and fetal outcome. All Singleton pregnancies delivering at Pakistan Railway Hospital Rawalpindi from January 2004 to December 2005 that fulfilled the required criteria were included. Out of the 860 patients, 402 were anemic (<11gm/dl) and 458 were non anemic. Perinatal outcome included preterm delivery, low birth weight, intrauterine growth retardation, perinatal death, low apgr scores and intrauterine fetal deaths. Risk of preterm and Low birth weight among anemic women was 3.4 and 1.8 times more than non anaemic women. The neonates of anemic woman also had 1.7 times increased risk of having low apgr scores at 1 min. Among anemic women there was 2.2 times greater risk of intrauterine fetal death than the non-anemic women. Regular antenatal care from first trimester has a vital role in assessing and managing maternal anemia timely and it directly affects the perinatal outcome. The patients with anemia have also higher risk of having low birth weight, preterm births and intra uterine fetal death. (author)

Greater Trochanteric Fixation Using a Cable System for Partial Hip Arthroplasty: A Clinical and Finite Element Analysis

Directory of Open Access Journals (Sweden)

Fırat Ozan

2014-01-01

Full Text Available The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA. Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%, good in 17 patients (53.1%, average in 5 patients (15.6%, and poor in 1 patient (9.3%. Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%, fibrous union in 12 (37.5%, and no union in 6 (18.7%. FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery.

Social information-processing and coping in adolescent females diagnosed with an eating disorder: toward a greater understanding of control.

Science.gov (United States)

McFillin, Roger K; Cahn, Stacey C; Burks, Virginia Salzer; Levine, Martha Peaslee; Loney, Susan Lane; Levine, Richard L

2012-01-01

The objective of this study was to examine differences in social information-processing and coping strategies between adolescent females in treatment for an eating disorder and asymptomatic peers. Adolescent females in treatment for an eating disorder (n = 50) were compared to asymptomatic control participants (n = 59) on a measure of social information-processing. Participants were presented with 4 hypothetical, ambiguous social dilemmas in which the intent of a peer provocateur was unclear. Questions followed each dilemma assessing intent attributions, the participant's emotional reaction, the intensity of the emotion, and coping strategies. The participants in treatment for an eating disorder were significantly more likely to perceive hostile intent from a peer provocateur, reported a greater intensity of negative emotions, and identified a significantly greater number of avoidant coping strategies. Specifically, the eating disorder group identified significantly more intrapunitive avoidant coping strategies that reflect maladaptive and self-destructive means of coping with distressing events. Results indicate social cognitive processing biases and maladaptive coping strategies may be instrumental in perceived loss of control and influence the development/maintenance of eating disorders.

The probability outcome correpondence principle : a dispositional view of the interpretation of probability statements

NARCIS (Netherlands)

Keren, G.; Teigen, K.H.

2001-01-01

This article presents a framework for lay people's internal representations of probabilities, which supposedly reflect the strength of underlying dispositions, or propensities, associated with the predicted event. From this framework, we derive the probability-outcome correspondence principle, which

Mindfulness and personal identity in the Western cultural context: A plea for greater cosmopolitanism.

Science.gov (United States)

Panaïoti, Antoine

2015-08-01

In the psychological sciences, mindfulness practices are increasingly being used, studied, and theorized, but their indigenous theoretical foundations in Buddhist accounts of the dynamics and psychology of personal identity tend to be overlooked. This situation is mirrored in the discipline of philosophy: here, Buddhist views on personal identity are beginning to draw attention, but almost invariably in a way which entirely blanks out the role of mindfulness practices in cultivating Buddhist insights on selfhood. The aggregate result is a failure, in the West, to reflect upon and seriously consider Buddhist theory and Buddhist practice in an integrated, holistic fashion. In its effort to overcome the compartmentalization of Buddhist theory (in philosophy) versus Buddhist practice (in psychology) and to embrace the challenges this might pose to fundamental Western beliefs about the self, this paper is intended both as a plea for and an exercise in greater, more venturesome cosmopolitanism. © The Author(s) 2015.

Urban trees and the risk of poor birth outcomes

Science.gov (United States)

Geoffrey H. Donovan; Yvonne L. Michael; David T. Butry; Amy D. Sullivan; John M. Chase

2011-01-01

This paper investigated whether greater tree-canopy cover is associated with reduced risk of poor birth outcomes in Portland, Oregon. Residential addresses were geocoded and linked to classified-aerial imagery to calculate tree-canopy cover in 50, 100, and 200 m buffers around each home in our sample (n=5696). Detailed data on maternal characteristics and additional...

Thoughts on Reflection (Editorial

Directory of Open Access Journals (Sweden)

Denise Koufogiannakis

2010-06-01

Full Text Available There has been some acknowledgement in the published literature that reflection is a crucial element of the evidence based library and information practice (EBLIP model we have adopted (Booth 2004, 2006; Grant 2007; Helliwell 2007. As we work through a problem and try to incorporate the best available evidence into our decision making, reflection is required at several stages, including the very identification of the problem through to our assessment of the process itself and what we have learned in order to inform future practice. However, reflection and reflective writing have not fully been integrated into the process we espouse, and very little has been done to look more closely at this element of the model and how it can be integrated into professional learning.In a recently published research article, Sen (2010 confirms the relationship between reflection and several aspects of professional practice. These include critical review and decision making, two aspects that are tied closely to the evidence based process. Sen notes: Students were more likely to show evidence of learning, self‐development, the ability to review issues crucially, awareness of their own mental functions, ability to make decision [sic] and being empowered when they had mastered the art of reflective practice and the more deeply analytical reflective writing. (p.84 EBLIP (the journal tries to incorporate elements of reflection within the articles we publish. While we clearly believe in the need for our profession to do quality research and publish that research so that it can be accessible to practitioners, we also know that research cannot be looked at in isolation. Our evidence summaries are one way of reflecting critically on previously published research, and in the same vein, our classics bring older research studies back to the foreground. This work needs to continue to be discussed and looked at for its impact on our profession.More directly, the Using

The Reflective Foundation

DEFF Research Database (Denmark)

Lunde Jørgensen, Ida

Private foundations and cultural philanthropy by élites is viewed with increasing skepticism in recent years, begging the question of the extent to which foundations reflect on their role vis a vis wider societal norms. Through the prism of the New Carlsberg Foundation, financed by the brewery...... Carlsberg A/S, the paper seeks to elucidate the way in which one culturally significant foundation from Denmark has reflected on - and legitimated - its work and investments at critical moments in the past decades. The paper indicates a foundation with a high degree of reflection on the wider societal...

Temperament and impulsivity predictors of smoking cessation outcomes.

Directory of Open Access Journals (Sweden)

Francisca López-Torrecillas

Full Text Available AIMS: Temperament and impulsivity are powerful predictors of addiction treatment outcomes. However, a comprehensive assessment of these features has not been examined in relation to smoking cessation outcomes. METHODS: Naturalistic prospective study. Treatment-seeking smokers (n = 140 were recruited as they engaged in an occupational health clinic providing smoking cessation treatment between 2009 and 2013. Participants were assessed at baseline with measures of temperament (Temperament and Character Inventory, trait impulsivity (Barratt Impulsivity Scale, and cognitive impulsivity (Go/No Go, Delay Discounting and Iowa Gambling Task. The outcome measure was treatment status, coded as "dropout" versus "relapse" versus "abstinence" at 3, 6, and 12 months endpoints. Participants were telephonically contacted and reminded of follow-up face to face assessments at each endpoint. The participants that failed to answer the phone calls or self-reported discontinuation of treatment and failed to attend the upcoming follow-up session were coded as dropouts. The participants that self-reported continuing treatment, and successfully attended the upcoming follow-up session were coded as either "relapse" or "abstinence", based on the results of smoking behavior self-reports cross-validated with co-oximetry hemoglobin levels. Multinomial regression models were conducted to test whether temperament and impulsivity measures predicted dropout and relapse relative to abstinence outcomes. RESULTS: Higher scores on temperament dimensions of novelty seeking and reward dependence predicted poorer retention across endpoints, whereas only higher scores on persistence predicted greater relapse. Higher scores on the trait dimension of non-planning impulsivity but not performance on cognitive impulsivity predicted poorer retention. Higher non-planning impulsivity and poorer performance in the Iowa Gambling Task predicted greater relapse at 3 and 6 months and 6 months

Early Treatment Outcome in Failure to Thrive: Predictions from a Transactional Model.

Science.gov (United States)

Drotar, Dennis

Children diagnosed with environmentally based failure to thrive early during their first year of life were seen at 12 and 18 months for assessment of psychological development (cognition, language, symbolic play, and behavior during testing). Based on a transactional model of outcome, factors reflecting biological vulnerability (wasting and…

Reflection-type hologram for atoms

International Nuclear Information System (INIS)

Shimizu, Fujio; Fujita, Jun-ichi

2002-01-01

A cold metastable neon atomic beam was manipulated with a reflective amplitude hologram that was encoded on a silicon surface. A black-and-white pattern of atoms was reconstructed on a microchannel plate detector. The hologram used the enhanced quantum reflection developed by authors and was made of a two-dimensional array of rectangular low and high reflective cells. The surface of the high reflective cell was composed of regularly spaced roof-shaped ridges, while the low reflective cell was simply a flat surface. The hologram was the first demonstration of reflective atom-optical elements that used universal interaction between a neutral atom and solid surface

Hyperglycemia and in-hospital outcomes after first myocardial infarction

International Nuclear Information System (INIS)

Khan, A.N.; Ambreen, F.; Qureshi, I.Z.

2006-01-01

To determine in-hospital outcomes post AMI hyperglycemia. 109 patients of acute myocardial infarction were included in this study. Physical examination, ECG tracings, random plasma glucose, serum cholesterol, triglycerides and cardiac enzymes (CPK, LDH and AST) were measured. Hyperglycemic patients (plasma glucose 126 mg/dl) were sub-divided into those with a previous history of diabetes and those without any such history. Post AMI plasma glucose levels were exceptionally higher in female patients aged 61-70 years while they were moderately higher in males of age groups 31-40 and 51-60, and females of age group 41-50 years. In-hospital mortality rate was greater in hyperglycemic patients. Most importantly also, significantly greater complications of the heart were encountered in hyperglycemics. Post AMI patients are at a greater risk of developing diabetes and concurrent AMI attack. (author)

A Trilogy of Unfortunate Events in China: Reflecting on the Management of Crises

OpenAIRE

Zhang A. Long; William Crandall; John Parnell

2010-01-01

In this paper, the authors address three recent organizational crises that have occurred in China; the SK-II cosmetic incident, the Sharon Stone comment on the May 2008 earthquake in China, and the melamine milk contamination crisis. Each held significant notoriety due to the crises involving major companies and an assortment of negative outcomes. After presenting an overview of each case, the authors outline their reflections on the management of these crises in relation to their cultural co...

Becoming Reflective and Inquiring Teachers: Collaborative Action Research for In-service Chilean Teachers

OpenAIRE

Martine Pellerin; Fraño Ivo Paukner Nogués

2015-01-01

This article discusses the outcomes of a case study that engaged Chilean in-service teachers in systematic action research (AR) as a means of improving their pedagogical practice and effecting changes in their educational context. The study involved six in-service teachers from a region of Chile and two university researchers. The findings show that knowledge of systematic AR provided the teachers with the necessary means to engage in a critical reflection and inquiry process regarding their ...

Welfare and Work: Job-Retention Outcomes of Federal Welfare-to-Work Employees.

Science.gov (United States)

Gooden, Susan Tinsley; Bailey, Margo

2001-01-01

Comparison of differences in job-retention outcomes for 1,777 welfare-to-work employees and 16,723 other employees in federal agencies reveals that welfare-to-work employees have greater odds of retaining their jobs. (Contains 32 references.) (JOW)

At-risk children's use of reflection and revision in hands-on experimental activities

Science.gov (United States)

Petrosino, Anthony J., Jr.

The goal of this study was to investigate the effects of incorporating opportunities for reflection and revision in hands-on science instruction which emphasized experimentation using model rockets. The participants were low achieving sixth grade summer school students (n = 23) designated as at-risk for school failure by their district. The group was asked a series of interview questions based on work by Schauble et al. (1995) relating to experimentation. The interviews took place over three distinct time points corresponding to a "hands-on only" condition, a "hands-on with reflection and revision" condition and a "hands-on with repeated reflection and revision" condition. A Friedman's Two-Way Analysis of Variance by Ranks indicate students score low at first with traditional hands-on instruction but improve significantly with opportunities to reflect and revise their experiments. In addition, a sociocultural analysis was conducted during the summer school session to assess the model rocket activity as an apprenticeship, as guided participation and as participatory appropriation using a framework established by Rogoff (1994). Finally, a survey (the Classroom Environment Survey) was administered to the students measuring five constructs consistent with a constructivist classroom: participation, autonomy, relevance, commitment to learning and disruptions to learning. Analysis indicate students in the summer school model rocket intervention experienced a greater sense of constructivist principles during the activity than a similar comparison group utilizing reform minded instruction but not including opportunities for reflection and revision cycles. This research provides important evidence that, like scientists, students in school can learn effectively from extended practice in a varied context. Importantly, the data indicate that hands-on instruction is best utilized when opportunities for reflection and revision are made explicit. Implications are discussed related

Structure-Function Analysis of Nonarteritic Anterior Ischemic Optic Neuropathy and Age-Related Differences in Outcome.

Science.gov (United States)

Sun, Ming-Hui; Liao, Yaping Joyce

2017-09-01

The optic nerve head is vulnerable to ischemia leading to anterior ischemic optic neuropathy (AION), the most common acute optic neuropathy in those older than 50 years of age. We performed a cross-sectional study of 55 nonarteritic anterior ischemic optic neuropathy (NAION) eyes in 34 patients to assess clinical outcome and perform structure-function correlations. The peak age of NAION onset was between 50 and 55 years. Sixty-seven percent of patients presented with their first event between the ages of 40 and 60 years, and 32% presented at ≤50 years. Those with NAION onset at age ≤50 years did not have significantly better visual outcome per logMAR visual acuity, automated perimetric mean deviation (PMD) or optical coherence tomography (OCT) measurements. Kaplan-Meier survival curve and multivariate Cox proportional regression analysis showed that age >50 years at NAION onset was associated with greater risk of second eye involvement, with hazard ratio of 20. Older age at onset was significantly correlated with greater thinning of the ganglion cell complex (GCC) (P = 0.022) but not with logMAR visual acuity, PMD, or thinning of retinal nerve fiber layer (RNFL). Using area under receiver operating characteristic curve analyses, we found that thinning of RNFL and GCC was best able to predict visual outcome, and that mean RNFL thickness >65 μm or macular GCC thickness >55 μm significantly correlated with good visual field outcome. We showed that NAION onset at age >50 years had a greater risk of second eye involvement. Patients with OCT mean RNFL thickness >65 μm and mean macular ganglion cell complex thickness >55 μm had better visual outcomes.

Non-invasive identification of metal-oxalate complexes on polychrome artwork surfaces by reflection mid-infrared spectroscopy.

Science.gov (United States)

Monico, Letizia; Rosi, Francesca; Miliani, Costanza; Daveri, Alessia; Brunetti, Brunetto G

2013-12-01

In this work a reflection mid-infrared spectroscopy study of twelve metal-oxalate complexes, of interest in art conservation science as alteration compounds, was performed. Spectra of the reference materials highlighted the presence of derivative-like and/or inverted features for the fundamental vibrational modes as result of the main contribution from the surface component of the reflected light. In order to provide insights in the interpretation of theses spectral distortions, reflection spectra were compared with conventional transmission ones. The Kramers-Kronig (KK) algorithm, employed to correct for the surface reflection distortions, worked properly only for the derivative-like bands. Therefore, to pay attention to the use of this algorithm when interpreting the reflection spectra is recommended. The outcome of this investigation was exploited to discriminate among different oxalates on thirteen polychrome artworks analyzed in situ by reflection mid-infrared spectroscopy. The visualization of the νs(CO) modes (1400-1200 cm(-1)) and low wavenumber bands (below 900 cm(-1)) in the raw reflection profiles allowed Ca, Cu and Zn oxalates to be identified. Further information about the speciation of different hydration forms of calcium oxalates were obtained by using the KK transform. The work proves reflection mid-infrared spectroscopy to be a reliable and sensitive spectro-analytical method for identifying and mapping different metal-oxalate alteration compounds on the surface of artworks, thus providing conservation scientists with a non-invasive tool to obtain information on the state of conservation and causes of alteration of artworks. Copyright © 2013 Elsevier B.V. All rights reserved.

Improving Student Learning Outcomes Marketing Strategy Lesson By Applying SFAE Learning Model

Directory of Open Access Journals (Sweden)

Winda Nur Rohmawati

2017-11-01

Full Text Available Research objectives for improving student learning outcomes on the subjects of marketing strategy through the implementation of model learning SFAE. This type of research this is a class action research using a qualitative approach which consists of two cycles with the subject Marketing X grade SMK YPI Darussalam 2 Cerme Gresik Regency. This research consists of four stages: (1 the Planning Act, (2 the implementation of the action, (3 observations (observation, and (4 Reflection. The result of the research shows that cognitive and affective learning outcomes of students have increased significantly.

Storage array reflection considerations

International Nuclear Information System (INIS)

Haire, M.J.; Jordan, W.C.; Taylor, R.G.

1997-01-01

The assumptions used for reflection conditions of single containers are fairly well established and consistently applied throughout the industry in nuclear criticality safety evaluations. Containers are usually considered to be either fully water reflected (i.e., surrounded by 6 to 12 in. of water) for safety calculations or reflected by 1 in. of water for nominal (structural material and air) conditions. Tables and figures are usually available for performing comparative evaluations of containers under various loading conditions. Reflection considerations used for evaluating the safety of storage arrays of fissile material are not as well established. When evaluating arrays, it has become more common for analysts to use calculations to demonstrate the safety of the array configuration. In performing these calculations, the analyst has considerable freedom concerning the assumptions made for modeling the reflection of the array. Considerations are given for the physical layout of the array with little or no discussion (or demonstration) of what conditions are bounded by the assumed reflection conditions. For example, an array may be generically evaluated by placing it in a corner of a room in which the opposing walls are far away. Typically, it is believed that complete flooding of the room is incredible, so the array is evaluated for various levels of water mist interspersed among array containers. This paper discusses some assumptions that are made regarding storage array reflection

Nonlinear reflection of a spherically divergent N-wave from a plane surface: Optical interferometry measurements in air

International Nuclear Information System (INIS)

Karzova, M.; Yuldashev, P.; Khokhlova, V.; Ollivier, S.; Blanc-Benon, Ph.

2015-01-01

Mach stem is a well-known structure typically observed in the process of strong (acoustic Mach numbers greater than 0.4) step-shock waves reflection from a rigid boundary. However, this phenomenon has been much less studied for weak shocks in nonlinear acoustic fields where Mach numbers are in the range from 0.001 to 0.01 and pressure waveforms have more complicated waveforms than step shocks. The goal of this work was to demonstrate experimentally how nonlinear reflection occurs in air for very weak spherically divergent acoustic spark-generated pulses resembling an N-wave. Measurements of reflection patterns were performed using a Mach-Zehnder interferometer. A thin laser beam with sub-millimeter cross-section was used to obtain the time resolution of 0.4 µs, which is 6 times higher than the time resolution of the condenser microphones. Pressure waveforms were reconstructed using the inverse Abel transform applied to the phase of the signal measured by the interferometer. The Mach stem formation was observed experimentally as a result of collision of the incident and reflected shock pulses. It was shown that irregular reflection of the pulse occurred in a dynamic way and the length of the Mach stem increased linearly while the pulse propagated along the surface. Since the front shock of the spark-generated pulse was steeper than the rear shock, irregular type of reflection was observed only for the front shock of the pulse while the rear shock reflection occurred in a regular regime

Nonlinear reflection of a spherically divergent N-wave from a plane surface: Optical interferometry measurements in air

Energy Technology Data Exchange (ETDEWEB)

Karzova, M., E-mail: masha@acs366.phys.msu.ru [Laboratoire de Mécanique des Fluides et d’Acoustique, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, 69134 Ecully (France); Physics Faculty, Moscow State University, Leninskie Gory, 119991 Moscow (Russian Federation); Yuldashev, P.; Khokhlova, V. [Physics Faculty, Moscow State University, Leninskie Gory, 119991 Moscow (Russian Federation); Ollivier, S.; Blanc-Benon, Ph. [Laboratoire de Mécanique des Fluides et d’Acoustique, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, 69134 Ecully (France)

2015-10-28

Mach stem is a well-known structure typically observed in the process of strong (acoustic Mach numbers greater than 0.4) step-shock waves reflection from a rigid boundary. However, this phenomenon has been much less studied for weak shocks in nonlinear acoustic fields where Mach numbers are in the range from 0.001 to 0.01 and pressure waveforms have more complicated waveforms than step shocks. The goal of this work was to demonstrate experimentally how nonlinear reflection occurs in air for very weak spherically divergent acoustic spark-generated pulses resembling an N-wave. Measurements of reflection patterns were performed using a Mach-Zehnder interferometer. A thin laser beam with sub-millimeter cross-section was used to obtain the time resolution of 0.4 µs, which is 6 times higher than the time resolution of the condenser microphones. Pressure waveforms were reconstructed using the inverse Abel transform applied to the phase of the signal measured by the interferometer. The Mach stem formation was observed experimentally as a result of collision of the incident and reflected shock pulses. It was shown that irregular reflection of the pulse occurred in a dynamic way and the length of the Mach stem increased linearly while the pulse propagated along the surface. Since the front shock of the spark-generated pulse was steeper than the rear shock, irregular type of reflection was observed only for the front shock of the pulse while the rear shock reflection occurred in a regular regime.

Overview of data-synthesis in systematic reviews of studies on outcome prediction models

NARCIS (Netherlands)

T. van den Berg (Tobias); M.W. Heymans (Martijn); O. Leone; D. Vergouw (David); J. Hayden (Jill); A.P. Verhagen (Arianne); H.C. de Vet (Henrica C)

2013-01-01

textabstractBackground: Many prognostic models have been developed. Different types of models, i.e. prognostic factor and outcome prediction studies, serve different purposes, which should be reflected in how the results are summarized in reviews. Therefore we set out to investigate how authors of

The Development of NOAA Education Common Outcome Performance Measures (Invited)

Science.gov (United States)

Baek, J.

2013-12-01

of an individual program, but does reflect a variety of contributions along a single dimension across a large portfolio of programs. The process has ended up pushing our working group to call for even more measures, to capture an increasing number of dimensions that reflect the nature of the portfolio of programs. This past year we have been working on developing two sets of common outcome performance measures for professional development (PD) and stewardship education programs. The outcome we chose for PD programs was the use of what was learned in the educator's practice. The outcome we chose for stewardship programs was the stewardship behaviors that participants learn and practice. The measurement of these outcomes will inform whether our strategies are having their intended impact. By knowing how and how much these outcomes are occurring as a result of our program, we can improve program performance over time. The common outcome performance measures help demonstrate how these programs engage audiences in supporting NOAA's mission. As AGU climate literacy community continues to grow, it is important to consider an approach to demonstrate the community's contribution to the Nation's climate literacy. Development of common outcome performance measures is one approach that could help focus the community in meeting its goals.

Reflectance Modeling

Science.gov (United States)

Smith, J. A.; Cooper, K.; Randolph, M.

1984-01-01

A classical description of the one dimensional radiative transfer treatment of vegetation canopies was completed and the results were tested against measured prairie (blue grama) and agricultural canopies (soybean). Phase functions are calculated in terms of directly measurable biophysical characteristics of the canopy medium. While the phase functions tend to exhibit backscattering anisotropy, their exact behavior is somewhat more complex and wavelength dependent. A Monte Carlo model was developed that treats soil surfaces with large periodic variations in three dimensions. A photon-ray tracing technology is used. Currently, the rough soil surface is described by analytic functions and appropriate geometric calculations performed. A bidirectional reflectance distribution function is calculated and, hence, available for other atmospheric or canopy reflectance models as a lower boundary condition. This technique is used together with an adding model to calculate several cases where Lambertian leaves possessing anisotropic leaf angle distributions yield non-Lambertian reflectance; similar behavior is exhibited for simulated soil surfaces.

Longitudinal observation of treatment patterns and outcomes for patients with fibromyalgia: 12-month findings from the reflections study.

Science.gov (United States)

Robinson, Rebecca L; Kroenke, Kurt; Williams, David A; Mease, Philip; Chen, Yi; Faries, Douglas; Peng, Xiaomei; Hann, Danette; Wohlreich, Madelaine; McCarberg, Bill

2013-09-01

To describe 12-month treatment patterns and outcomes for patients starting a new medication for fibromyalgia in routine clinical practice. Data from 1,700 patients were collected at baseline and 1, 3, 6, and 12 months. Repeated measures and Poisson regression models controlling for demographic, clinical, and baseline outcomes were used to assess changes in health outcomes (Brief Pain Inventory severity and interference, Sheehan Disability Scale, Fibromyalgia Impact Questionnaire), satisfaction, and economic factors for patients who initiated on pregabalin (214, 12.6%), duloxetine (264, 15.5%), milnacipran (134, 7.9%), or tricyclic antidepressants (66, 3.9%). Sensitivity analyses were run using propensity-matched cohorts. Patients started on 145 unique drugs for fibromyalgia, and over 75% of patients took two or more medications concurrently for fibromyalgia at each time point assessed. Overall, patients showed improvement on the four health outcomes, with few differences across medication cohorts. At baseline, patients reported annual averages of 20.3 visits for outpatient care, 27.7 missed days of work, and 32.6 days of care by an unpaid caregiver. The duloxetine and milnacipran (vs pregabalin or tricyclic antidepressant) cohorts had fewer outpatient visits during the 12-month study. Patients reported satisfaction with overall treatment and their fibromyalgia medication (46.0% and 42.8%, respectively). In this real-world setting, patients with fibromyalgia reported modest improvements, high resource, and medication use, and were satisfied with the care they received. Cohort differences were difficult to discern because of the high rates of drug discontinuation and concomitant medication use over the 12-month study period. Wiley Periodicals, Inc.

Methods for reducing singly reflected rays on the Wolter-I focusing mirrors of the FOXSI rocket experiment

Science.gov (United States)

Buitrago-Casas, Juan Camilo; Elsner, Ronald; Glesener, Lindsay; Christe, Steven; Ramsey, Brian; Courtade, Sasha; Ishikawa, Shin-nosuke; Narukage, Noriyuki; Turin, Paul; Vievering, Juliana; Athiray, P. S.; Musset, Sophie; Krucker, Säm.

2017-08-01

In high energy solar astrophysics, imaging hard X-rays by direct focusing offers higher dynamic range and greater sensitivity compared to past techniques that used indirect imaging. The Focusing Optics X-ray Solar Imager (FOXSI) is a sounding rocket payload that uses seven sets of nested Wolter-I figured mirrors together with seven high-sensitivity semiconductor detectors to observe the Sun in hard X-rays through direct focusing. The FOXSI rocket has successfully flown twice and is funded to fly a third time in summer 2018. The Wolter-I geometry consists of two consecutive mirrors, one paraboloid and one hyperboloid, that reflect photons at grazing angles. Correctly focused X-rays reflect once per mirror segment. For extended sources, like the Sun, off-axis photons at certain incident angles can reflect on only one mirror and still reach the focal plane, generating a background pattern of singly reflected rays (i.e., ghost rays) that can limit the sensitivity of the observation to faint, focused sources. Understanding and mitigating the impact of the singly reflected rays on the FOXSI optical modules will maximize the instruments' sensitivity to background-limited sources. We present an analysis of the FOXSI singly reflected rays based on ray-tracing simulations and laboratory measurements, as well as the effectiveness of different physical strategies to reduce them.

Major depressive disorder is characterized by greater reward network activation to monetary than pleasant image rewards.

Science.gov (United States)

Smoski, Moria J; Rittenberg, Alison; Dichter, Gabriel S

2011-12-30

Anhedonia, the loss of interest or pleasure in normally rewarding activities, is a hallmark feature of unipolar Major Depressive Disorder (MDD). A growing body of literature has identified frontostriatal dysfunction during reward anticipation and outcomes in MDD. However, no study to date has directly compared responses to different types of rewards such as pleasant images and monetary rewards in MDD. To investigate the neural responses to monetary and pleasant image rewards in MDD, a modified Monetary Incentive Delay task was used during functional magnetic resonance imaging to assess neural responses during anticipation and receipt of monetary and pleasant image rewards. Participants included nine adults with MDD and 13 affectively healthy controls. The MDD group showed lower activation than controls when anticipating monetary rewards in right orbitofrontal cortex and subcallosal cortex, and when anticipating pleasant image rewards in paracingulate and supplementary motor cortex. The MDD group had relatively greater activation in right putamen when anticipating monetary versus pleasant image rewards, relative to the control group. Results suggest reduced reward network activation in MDD when anticipating rewards, as well as relatively greater hypoactivation to pleasant image than monetary rewards. 2011 Elsevier Ireland Ltd. All rights reserved.

Reflection Revisited: The Class Collage

Science.gov (United States)

Sommers, Jeff

2011-01-01

Through the regular use of what Donald Schon has termed reflection-in-action and reflection-on-action, students can learn to improve their "reflection-in-presentation," in Kathleen Blake Yancey's term. Students are often asked to do this type of reflection-in-presentation as a capstone to first-year or basic writing courses. However, a number of…

Interventions to Support Integrated Psychological Care and Holistic Health Outcomes in Paediatrics.

Science.gov (United States)

Shafran, Roz; Bennett, Sophie D; McKenzie Smith, Mhairi

2017-08-16

There are strong calls from many national and international bodies for there to be a 'holistic' and integrated approach to the understanding and management of psychological and physical health needs. Such holistic approaches are characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease. Holistic approaches can impact on mental and physical health and are cost-effective. Several psychological interventions have demonstrated efficacy in improving holistic health outcomes, for example Cognitive Behaviour Therapy, Behavioural Therapies and Problem Solving Therapies. They have shown to impact upon a wide range of outcomes, including psychological distress, pain, physical health, medication adherence, and family outcomes. There is increasing recognition that the holistic goals of the child and family should be prioritised, and that interventions and outcomes should reflect these goals. A focus on holistic goals in therapy can be achieved through a combination of personalised goal-based outcomes in addition to symptom-based measures.

Reflection: A Socratic approach.

Science.gov (United States)

Van Seggelen-Damen, Inge C M; Van Hezewijk, René; Helsdingen, Anne S; Wopereis, Iwan G J H

2017-12-01

Reflection is a fuzzy concept. In this article we reveal the paradoxes involved in studying the nature of reflection. Whereas some scholars emphasize its discursive nature, we go further and underline its resemblance to the self-biased dialogue Socrates had with the slave in Plato's Meno . The individual and internal nature of the reflection process creates difficulty for studying it validly and reliably. We focus on methodological issues and use Hans Linschoten's view of coupled systems to identify, analyze, and interpret empirical research on reflection. We argue that researchers and research participants can take on roles in several possible system couplings. Depending on who controls the manipulation of the stimulus, who controls the measuring instrument, who interprets the measurement and the response, different types of research questions can be answered. We conclude that reflection may be validly studied by combining different couplings of experimenter, manipulation, stimulus, participant, measurement, and response.

Using a Smartphone App and Coaching Group Sessions to Promote Residents' Reflection in the Workplace.

Science.gov (United States)

Könings, Karen D; van Berlo, Jean; Koopmans, Richard; Hoogland, Henk; Spanjers, Ingrid A E; ten Haaf, Jeroen A; van der Vleuten, Cees P M; van Merriënboer, Jeroen J G

2016-03-01

Reflecting on workplace-based experiences is necessary for professional development. However, residents need support to raise their awareness of valuable moments for learning and to thoughtfully analyze those learning moments afterwards. From October to December 2012, the authors held a multidisciplinary six-week postgraduate training module focused on general competencies. Residents were randomly assigned to one of four conditions with varying degrees of reflection support; they were offered (1) a smartphone app, (2) coaching group sessions, (3) a combination of both, or (4) neither type of support. The app allowed participants to capture in real time learning moments as a text note, audio recording, picture, or video. Coaching sessions held every two weeks aimed to deepen participants' reflection on captured learning moments. Questionnaire responses and reflection data were compared between conditions to assess the effects of the app and coaching sessions on intensity and frequency of reflection. Sixty-four residents participated. App users reflected more often, captured more learning moments, and reported greater learning progress than nonapp users. Participants who attended coaching sessions were more alert to learning moments and pursued more follow-up learning activities to improve on the general competencies. Those who received both types of support were most alert to these learning moments. A simple mobile app for capturing learning moments shows promise as a tool to support workplace-based learning, especially when combined with coaching sessions. Future research should evaluate these tools on a broader scale and in conjunction with residents' and students' personal digital portfolios.

Flexible ureteroscopy versus percutaneous nephrolithotomy as primary treatment for renal stones 2 cm or greater

Directory of Open Access Journals (Sweden)

Akar EC

2013-01-01

Full Text Available Erin Akar, Bodo E KnudsenDepartment of Urology, Ohio State University Wexner Medical Center, Columbus, OH, USAAbstract: The purpose of this review, based on the current evidence in the literature, is whether ureteroscopy (URS is a comparable primary treatment option to the current gold standard of percutaneous nephrolithotomy (PCNL for the treatment of large kidney stones 2 cm or greater. The lack of prospective randomized trials directly comparing URS and PCNL makes comparison challenging. The numerous studies are not standardized in terms of their definition of stone-free or how stone size is reported. In order to standardize comparison of results, we used a stone-free definition of <4 mm after one procedure per imaging of the author’s choice, since how each patient was imaged postoperatively was not reported. The results from the literature show that moderately large stones from 2 to 3 cm treated ureteroscopically have similar outcomes to PCNL. Stone-free rates with URS decrease when stone size is above 3 cm. Our interpretation of the literature suggests that a current limitation of URS is that multiple procedures for URS would be required to achieve comparable stone-free rates to PCNL, particularly for stones greater than 4 cm.Keywords: ureteroscopy, percutaneous nephrolithotomy, lithotripsy, urinary calculi

Lexical neutrality in environmental health research: Reflections on the term walkability.

Science.gov (United States)

Hajna, Samantha; Ross, Nancy A; Griffin, Simon J; Dasgupta, Kaberi

2017-12-08

Neighbourhood environments have important implications for human health. In this piece, we reflect on the environments and health literature and argue that precise use of language is critical for acknowledging the complex and multifaceted influence that neighbourhood environments may have on physical activity and physical activity-related outcomes. Specifically, we argue that the term "neighbourhood walkability", commonly used in the neighbourhoods and health literature, constrains recognition of the breadth of influence that neighbourhood environments might have on a variety of physical activity behaviours. The term draws attention to a single type of physical activity and implies that a universal association exists when in fact the literature is quite mixed. To maintain neutrality in this area of research, we suggest that researchers adopt the term "neighbourhood physical activity environments" for collective measures of neighbourhood attributes that they wish to study in relation to physical activity behaviours or physical activity-related health outcomes.

Parental Book Reading and Social-Emotional Outcomes for Head Start Children in Foster Care.

Science.gov (United States)

Lee, Kyunghee; Lee, Jung-Sook

2016-01-01

This study examines the associations between parental book reading and social-emotional outcomes for Head Start children in foster care. Despite no main Head Start impact on parental book reading, subgroup effects were found. Foster parents in Head Start provided more book reading for children with disabilities but less for children with low preacademic scores. Head Start enhanced social-emotional outcomes for children in foster care. The positive impacts of Head Start on children's social-emotional outcomes were greater when parents read books frequently. Head Start should include more foster families and provided parenting skills to enhance social-emotional outcomes for children in foster care.

Re-thinking reflection in supervision

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

The paper presents a socio-cultural perspective on supervision in professional education, which challenges the current reflective paradigm and move the debate on reflection in supervision in professional education and learning towards a recognition of context, power dynamics and ideological...... of reflective practice has been formalized by regulatory bodies as a way to develop the professionalism of both individual professional practitioners as students through continuing professional developmental processes. Consequently, reflection is often used as a `tool´ for personal and professional development...... al., 2010). This conceptual paper presents a critical, socio-cultural perspective on the current paradigm or dogma of reflective practice within supervision in professional education and learning. The purpose I to challenge the dogma and critically to analyze and move the debate on reflection...

Demystifying the reflective clinical journal

International Nuclear Information System (INIS)

Milinkovic, Danielle; Field, Nikki

2005-01-01

Student learning on clinical placement is a complex issue and cannot be defined solely by just doing things. Reflection during clinical practice is essential if the student is going to learn from the experience. Therefore it is important for educators to include as part of clinical education programs learning strategies that encourage reflection. The reflective clinical journal is an educational tool that is employed by the School of Medical Radiation Sciences at the University of Sydney to encourage reflection of undergraduate radiation therapy students whilst on clinical placement. This discussion paper explores the key concepts of reflection and the reflective clinical journal. Due to the paucity of information about this issue in radiation therapy the literature reviewed is from across all areas of the health sciences

Neighborhood Deprivation and Childhood Asthma Outcomes, Accounting for Insurance Coverage.

Science.gov (United States)

Nkoy, Flory L; Stone, Bryan L; Knighton, Andrew J; Fassl, Bernhard A; Johnson, Joseph M; Maloney, Christopher G; Savitz, Lucy A

2018-01-09

Collecting social determinants data is challenging. We assigned patients a neighborhood-level social determinant measure, the area of deprivation index (ADI), by using census data. We then assessed the association between neighborhood deprivation and asthma hospitalization outcomes and tested the influence of insurance coverage. A retrospective cohort study of children 2 to 17 years old admitted for asthma at 8 hospitals. An administrative database was used to collect patient data, including hospitalization outcomes and neighborhood deprivation status (ADI scores), which were grouped into quintiles (ADI 1, the least deprived neighborhoods; ADI 5, the most deprived neighborhoods). We used multivariable models, adjusting for covariates, to assess the associations and added a neighborhood deprivation status and insurance coverage interaction term. A total of 2270 children (median age 5 years; 40.6% girls) were admitted for asthma. We noted that higher ADI quintiles were associated with greater length of stay, higher cost, and more asthma readmissions ( P < .05 for most quintiles). Having public insurance was independently associated with greater length of stay (β: 1.171; 95% confidence interval [CI]: 1.117-1.228; P < .001), higher cost (β: 1.147; 95% CI: 1.093-1.203; P < .001), and higher readmission odds (odds ratio: 1.81; 95% CI: 1.46-2.24; P < .001). There was a significant deprivation-insurance effect modification, with public insurance associated with worse outcomes and private insurance with better outcomes across ADI quintiles ( P < .05 for most combinations). Neighborhood-level ADI measure is associated with asthma hospitalization outcomes. However, insurance coverage modifies this relationship and needs to be considered when using the ADI to identify and address health care disparities. Copyright © 2018 by the American Academy of Pediatrics.

'Combined reflectance stratigraphy' - subdivision of loess successions by diffuse reflectance spectrometry (DRS)

Science.gov (United States)

Szeberényi, Jozsef; Bradak-Hayashi, Balázs; Kiss, Klaudia; Kovács, József; Varga, György; Balázs, Réka; Szalai, Zoltán; Viczián, István

2016-04-01

The different varieties of loess (and intercalated paleosol layers) together constitute one of the most widespread terrestrial sediments, which was deposited, altered, and redeposited in the course of the changing climatic conditions of the Pleistocene. To reveal more information about Pleistocene climate cycles and/or environments the detailed lithostratigraphical subdivision and classification of the loess variations and paleosols are necessary. Beside the numerous method such as various field measurements, semi-quantitative tests and laboratory investigations, diffuse reflectance spectroscopy (DRS) is one of the well applied method on loess/paleosol sequences. Generally, DRS has been used to separate the detrital and pedogenic mineral component of the loess sections by the hematite/goethite ratio. DRS also has been applied as a joint method of various environmental magnetic investigations such as magnetic susceptibility- and isothermal remanent magnetization measurements. In our study the so-called "combined reflectance stratigraphy method" were developed. At First, complex mathematical method was applied to compare the results of the spectral reflectance measurements. One of the most preferred multivariate methods is cluster analysis. Its scope is to group and compare the loess variations and paleosol based on the similarity and common properties of their reflectance curves. In the Second, beside the basic subdivision of the profiles by the different reflectance curves of the layers, the most characteristic wavelength section of the reflectance curve was determined. This sections played the most important role during the classification of the different materials of the section. The reflectance value of individual samples, belonged to the characteristic wavelength were depicted in the function of depth and well correlated with other proxies like grain size distribution and magnetic susceptibility data. The results of the correlation showed the significance of

The Relationship between Career Decision-Making Self-Efficacy and Vocational Outcome Expectations of Preservice Special Education Teachers

Science.gov (United States)

Baglama, Basak; Uzunboylu, Huseyin

2017-01-01

Social cognitive career theory, which is one of the most studied career approaches, recently proposed that self-efficacy and outcome expectations are important determinants of the career choice process. Career self-efficacy and vocational outcome expectations might both result in avoiding or having greater motivation levels in terms of career…

The impact of financial and nonfinancial incentives on business-unit outcomes over time.

Science.gov (United States)

Peterson, Suzanne J; Luthans, Fred

2006-01-01

Unlike previous behavior management research, this study used a quasi-experimental, control group design to examine the impact of financial and nonfinancial incentives on business-unit (21 stores in a fast-food franchise corporation) outcomes (profit, customer service, and employee turnover) over time. The results showed that both types of incentives had a significant impact on all measured outcomes. The financial incentive initially had a greater effect on all 3 outcomes, but over time, the financial and nonfinancial incentives had an equally significant impact except in terms of employee turnover. (c) 2006 APA, all rights reserved.

Who Are You More Likely to Help? The Effects of Expected Outcomes and Regulatory Focus on Prosocial Performance

Science.gov (United States)

Xiao, Fengqiu; Zheng, Zhiwei; Zhang, Heyi; Xin, Ziqiang; Chen, Yinghe; Li, Yiwei

2016-01-01

Prosocial behavior refers to a broad category of actions that benefit other people or the society. Compared with other factors that affect prosocial performance, prosocial outcomes, consisting of prosocial gains and prosocial non-losses have received less attention up to now. In the current research, we explored the influences of different types of expected outcomes and regulatory focus on prosocial performance. Studies 1a and 1b examined the differences in prosocial performance elicited by prosocial gain (e.g., enhancing others’ access to clean water) and prosocial non-loss outcomes (e.g., protecting others from suffering dirty water). We found that the expected prosocial non-loss outcomes induced greater prosocial performance compared with the expected prosocial gain outcomes. Studies 2a and 2b examined the effects of dispositional and situational regulatory focus on prosocial loss aversion. We found that differences in prosocial performance between two expected prosocial outcomes were reduced when promotion focus was primed; whereas a primed prevention focus did not significantly increase this difference. Additionally, participants displayed a greater prosocial loss aversion in the prevention focus condition than in the promotion focus condition. The reason for the non-significant interaction between regulatory focus and expected prosocial outcome was discussed. PMID:27824909

Who Are You More Likely to Help? The Effects of Expected Outcomes and Regulatory Focus on Prosocial Performance.

Directory of Open Access Journals (Sweden)

Fengqiu Xiao

Full Text Available Prosocial behavior refers to a broad category of actions that benefit other people or the society. Compared with other factors that affect prosocial performance, prosocial outcomes, consisting of prosocial gains and prosocial non-losses have received less attention up to now. In the current research, we explored the influences of different types of expected outcomes and regulatory focus on prosocial performance. Studies 1a and 1b examined the differences in prosocial performance elicited by prosocial gain (e.g., enhancing others' access to clean water and prosocial non-loss outcomes (e.g., protecting others from suffering dirty water. We found that the expected prosocial non-loss outcomes induced greater prosocial performance compared with the expected prosocial gain outcomes. Studies 2a and 2b examined the effects of dispositional and situational regulatory focus on prosocial loss aversion. We found that differences in prosocial performance between two expected prosocial outcomes were reduced when promotion focus was primed; whereas a primed prevention focus did not significantly increase this difference. Additionally, participants displayed a greater prosocial loss aversion in the prevention focus condition than in the promotion focus condition. The reason for the non-significant interaction between regulatory focus and expected prosocial outcome was discussed.

Effect of moderate to vigorous physical activity on long-term clinical outcomes and pain severity in fibromyalgia.

Science.gov (United States)

Kaleth, Anthony S; Saha, Chandan K; Jensen, Mark P; Slaven, James E; Ang, Dennis C

2013-08-01

To evaluate the relationship between long-term maintenance of moderate to vigorous physical activity (MVPA) and clinical outcomes in fibromyalgia (FM). Patients with FM (n = 170) received individualized exercise prescriptions and completed baseline and followup physical activity assessments using the Community Health Activities Model Program for Seniors questionnaire at weeks 12, 24, and 36. The primary outcome was the change in the Fibromyalgia Impact Questionnaire-Physical Impairment (FIQ-PI) score. The secondary outcomes included improvements in overall well-being (FIQ total score), pain severity ratings, and depression. Using a threshold increase in MVPA of ≥10 metabolic equivalent hours/week above usual activities, 27 subjects (15.9%) increased and sustained (SUS-PA), 68 (40%) increased but then declined (UNSUS-PA), and 75 (44.1%) did not achieve (LO-PA) this benchmark. Compared to LO-PA subjects, both SUS-PA and UNSUS-PA subjects reported greater improvement in FIQ-PI (P physical function and overall well-being in patients with FM. Although sustained physical activity was not associated with greater clinical benefit compared with unsustained physical activity, these findings also suggest that performing greater volumes of physical activity is not associated with worsening pain in FM. Future research is needed to determine the relationship between sustained MVPA participation and subsequent improvement in patient outcomes. Copyright © 2013 by the American College of Rheumatology.

Reflective optics

CERN Document Server

Korsch, Dietrich

1991-01-01

This is the first book dedicated exclusively to all-reflective imaging systems. It is a teaching tool as well as a practical design tool for anyone who specializes in optics, particularly for those interested in telescopes, infrared, and grazing-incidence systems. The first part of the book describes a unified geometric optical theory of all-reflective imaging systems (from near-normal to grazing incidence) developed from basic principles. The second part discusses correction methods and a multitude of closed-form solutions of well-corrected systems, supplemented with many conventional and unc

Sexual Harassment, Bullying, and School Outcomes for High School Girls and Boys.

Science.gov (United States)

Gruber, James; Fineran, Susan

2016-01-01

A comparison of the impact of bullying and sexual harassment on five school outcomes was conducted on a sample of high school students. Results revealed that sexual harassment was a stronger predictor than bullying of all school outcomes for both sexes, but especially for girls. This study suggests that sexual harassment, which activates sexist and heterosexist stereotypes, erodes school engagement, alienates students from teachers, and adversely affects academic achievement, to a greater degree than bullying does. © The Author(s) 2015.

Clinical and economic outcomes in a population-based European cohort of 948 ulcerative colitis and Crohn's disease patients by Markov analysis

DEFF Research Database (Denmark)

Odes, S.; Vardi, H.; Friger, M.

2010-01-01

.66 in CD. Both diseases had similar likelihood of persistent drug-dependency or drug-refractoriness. Surgery was more probable in CD, 0.20, than UC, 0.08. In terms of economic outcomes, surgery was costlier in UC per cycle, but the outlay over 10 years was greater in CD. Drug-refractory UC and CD cases......P>Background Forecasting clinical and economic outcomes in ulcerative colitis (UC) and Crohn's disease (CD) patients is complex, but necessary. Aims To determine: the frequency of treatment-classified clinical states; the probability of transition between states; and the economic outcomes. Methods...... engendered high costs in the cohort. Conclusions Most patients on 5-aminosalicylates, corticosteroids and immunomodulators had favourable clinical and economic outcomes over 10 years. Drug-refractory and surgical patients exhibited greater long-term expenses...

Mapping Learning Outcomes and Assignment Tasks for SPIDER Activities

Directory of Open Access Journals (Sweden)

Lyn Brodie

2011-05-01

Full Text Available Modern engineering programs have to address rapidly changing technical content and have to enable students to develop transferable skills such as critical evaluation, communication skills and lifelong learning. This paper introduces a combined learning and assessment activity that provides students with opportunities to develop and practice their soft skills, but also extends their theoretical knowledge base. Key tasks included self directed inquiry, oral and written communication as well as peer assessment. To facilitate the SPIDER activities (Select, Prepare and Investigate, Discuss, Evaluate, Reflect, a software tool has been implemented in the learning management system Moodle. Evidence shows increased student engagement and better learning outcomes for both transferable as well as technical skills. The study focuses on generalising the relationship between learning outcomes and assignment tasks as well as activities that drive these tasks. Trail results inform the approach. Staff evaluations and their views of assignments and intended learning outcomes also supported this analysis.

Fertility rates and perinatal outcomes of adolescent pregnancies: a retrospective population-based study

Directory of Open Access Journals (Sweden)

Maria de Lourdes de Souza

Full Text Available ABSTRACT Objective: analyze trends in fertility rates and associations with perinatal outcomes for adolescents in Santa Catarina, Brazil. Methods: a population-based study covering 2006 to 2013 was carried out to evaluate associations between perinatal outcomes and age groups, using odds ratios, and Chi-squared tests. Results: differences in the fertility rate among female adolescents across regions and time period were observed, ranging from 40.9 to 72.0 per 1,000 in mothers aged 15-19 years. Adolescents had fewer prenatal care appointments than mothers ≥20 years, and a higher proportion had no partner. Mothers aged 15-19 years were more likely to experience preterm birth (OR:1.1; CI:1.08-1.13; p<0.001, have an infant with low birthweight (OR:1.1; CI:1.10-1.15; p<0.001 and low Apgar score at 5 minutes (OR:1.4; CI:1.34-1.45; p<0.001 than mothers ≥20 years, with the odds for adverse outcomes greater for those aged 10-14 years. Conclusion: this study provides evidence of fertility rates among adolescents remaining higher in regions of social and economic deprivation. Adolescent mothers and their infants more likely to experience adverse perinatal outcomes. Nurses, public health practitioners, health and social care professionals and educators need to work collaboratively to better target strategies for adolescents at greater risk; to help reduce fertility rates and improve outcomes.

Persistent ovarian masses and pregnancy outcomes.

Science.gov (United States)

Goh, William A; Rincon, Monica; Bohrer, Justin; Tolosa, Jorge E; Sohaey, Roya; Riaño, Rene; Davis, James; Zalud, Ivica

2013-07-01

To determine if persistent ovarian masses in pregnancy are associated with increased adverse outcomes. This is a retrospective cohort of 126 pregnant women with a persistent ovarian mass measuring 5 cm or greater who delivered at two university hospitals between 2001 and 2009. Maternal outcomes included gestational age (GA) at diagnosis, delivery and surgery as well as miscarriage, preterm birth (PTB), ovarian torsion and hospital admission for pain. Neonatal outcomes included birth weight, respiratory distress syndrome (RDS), intra-ventricular hemorrhage (IVH), death and sepsis. A total of 1225 ovarian masses were identified (4.9%) in 24,868 patients. A persistent ovarian mass was found in 0.7%. Average GA at diagnosis was 17.8 weeks. Miscarriage rate was 3.3%. Average GA at delivery was 37.9 weeks. Of the patients, 8.5% had ovarian torsion, 10.3% had admission for pain and 9.3% had PTBs. The mean cesarean delivery rate was 46.3%. The average neonatal weight was 3273 g. There was one neonatal death in this cohort. The rate of RDS was 2.8%, IVH 0.9% and neonatal sepsis 1.9%. The most common surgical pathologic diagnosis was dermoids (37.6%). No overt malignancies were seen. A persistent ovarian mass in pregnancy does not confer an increased risk of adverse pregnancy outcomes.

Learning outcomes afforded by self-assessed, segmented video–print combinations

OpenAIRE

Jack Koumi

2015-01-01

Learning affordances of video and print are examined in order to assess the learning outcomes afforded by hybrid video–print learning packages. The affordances discussed for print are: navigability, surveyability and legibility. Those discussed for video are: design for constructive reflection, provision of realistic experiences, presentational attributes, motivational influences and teacher personalisation. The video affordances are examined through a framework of pedagogic design principles...

Reflective Practice for Psychology Students: The Use of Reflective Journal Feedback in Higher Education

Science.gov (United States)

Bruno, Andreina; Dell'Aversana, Giuseppina

2017-01-01

Reflective journals have emerged as an effective means of monitoring and developing reflective practice in higher education, as part of a wider metacognitive strategy to transform traditional learning approaches. In addition, assessment procedures of reflective journals appear to be an important factor in enhancing commitment to learning and…

Update on course and outcome in eating disorders.

Science.gov (United States)

Keel, Pamela K; Brown, Tiffany A

2010-04-01

To review recent studies describing eating disorder course and outcome. Electronic and manual searches were conducted to identify relevant articles published since 2004. Twenty-six articles were identified. For anorexia nervosa (AN), most patients ascertained through outpatient settings achieved remission by 5-year follow-up. Inpatient treatment predicted poor prognosis as inpatient samples demonstrated lower remission rates. Outcome differed between bulimia nervosa (BN) and eating disorders not otherwise specified (EDNOS), including binge eating disorder (BED), for shorter follow-up durations; however, outcomes appeared similar between BN and related EDNOS by 5-year follow-up. Greater psychiatric comorbidity emerged as a significant predictor of poor prognosis in BN, whereas few prognostic indicators were identified for BED or other EDNOS. Results support optimism for most patients with eating disorders. However, more effective treatments are needed for adult AN inpatients and approximately 30% of patients with BN and related EDNOS who remain ill 10-20 years following presentation.

Systematic Review of Treatment Outcome Measures for Vulvodynia.

Science.gov (United States)

Sadownik, Leslie A; Yong, Paul J; Smith, Kelly B

2018-07-01

To systematically evaluate the literature regarding vulvodynia treatment outcome measures. A systematic literature search on OVID, PubMed, and PsycINFO databases was conducted from inception until May 2016. Studies were included/excluded based on prespecified criteria. Reported outcome measures were organized into 6 core outcome domains recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT): pain; physical functioning, emotional functioning, participant ratings of global improvement and satisfaction with treatment, symptoms and adverse events, and participant disposition. Of the 206 articles identified for full-text screening, 33 met our criteria. One study adhered to all IMMPACT recommendations. The number of outcomes measured per study ranged from 1 to greater than 20. Patient-reported pain outcomes were found in the majority (27/33; 82%) of studies. Pain severity with intercourse was reported by 24 (73%) of 33 studies-9 different scales were used to measure this outcome. Clinician-reported outcomes were present in 14 (42%) of 33 studies. Methods of measuring vestibular sensitivity by "cotton swab" test were different in 8 of 10 studies. Other domains reported included; physical function (8/33 studies; 24%), sexual function (23/33 studies; 70%), and emotional function (13/33 studies; 39%). Symptoms and adverse events were reported by 15 (45%) of 33 studies. One study formally reported participant disposition using all the information recommended by CONSORT. Comparison of clinical trial results in vulvodynia is not possible because of a lack of standard treatment outcome measures. Vulvodynia researchers should apply the IMMPACT criteria to guide the development of a minimum core set of standard outcome measures that measure holistic health.

Guided and Unguided Student Reflections

OpenAIRE

Matheson, Amanda; Wood, Laura; Franklin, Scott V.

2017-01-01

Self-reflection is important metacognitive skill, enabling students to build coherence into their learning and embed content in a broader context. While various pedagogical techniques exist to encourage student reflection, little research has examined the differences between formally guided, partially guided and unguided reflections. This study focuses on student responses to online Guided Reflection Forms (GRFs) from students in a first-semester non-physics class and, separately, a sophomore...

Effectuation And Reflection-In-Action

DEFF Research Database (Denmark)

Gertsen, Frank; Lervang, Johan-Ulrik; Maack, Karl

2013-01-01

Our main aim is to facilitate a reflective methodology for MSc thesis students in practical entrepreneurship that draws on the ideas of ‘reflection-in-action’ while simultaneously making use of the effectuation logics.......Our main aim is to facilitate a reflective methodology for MSc thesis students in practical entrepreneurship that draws on the ideas of ‘reflection-in-action’ while simultaneously making use of the effectuation logics....

IRAS surface brightness maps of visible reflection nebulae: evidence for non-equilibrium infrared emission

International Nuclear Information System (INIS)

Castelaz, M.W.; Werner, M.W.; Sellgren, K.

1986-01-01

Surface brightness maps at 12, 25, 60, and 100 microns of 16 visible reflection nebulae were extracted from the Infrared Astronomy Satellite (IRAS) database. The maps were produced by coadding IRAS survey scans over areas centered on the illuminating stars, and have spatial resolutions of 0.9' x 4' at 12 and 25 microns, 1.8' x 4.5' at 60 microns, and 3.6' x 5' at 100 microns. Extended emission in the four IRAS bandpasses was detected in fourteen of the reflection nebulae. The IRAS data were used to measure the flux of the infrared emission associated with each source. The energy distributions show that the 12 micron flux is greater than the 25 micron flux in 11 of the nebulae, and the peak flux occurs in the 60 or 100 micron bandpass in all 16 nebular. The 60 and 100 micron flux can be approximated by blackbodies with temperatures between 30 and 50 K, consistent with temperatures expected from extrapolation of greybody fits to the 60 and 100 micron data. The excess 12 and 25 micron emission is attributed to a nonequilibrium process such as emission from thermal fluctuations of very small grains excited by single ultraviolet photons, or emission from polycyclic aromatic hydrocarbons (PAHs) excited by ultraviolet radiation. The common features of the energy distributions of the 16 reflection nebulae, also seen in the reflection nebulae associated with the Pleiades, suggest that PAHs or very small grains may be found in most reflection nebulae

Depression, social support, and clinical outcomes following lung transplantation: a single-center cohort study.

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Smith, Patrick J; Snyder, Laurie D; Palmer, Scott M; Hoffman, Benson M; Stonerock, Gregory L; Ingle, Krista K; Saulino, Caroline K; Blumenthal, James A

2018-05-01

Depressive symptoms are common among lung transplant candidates and have been associated with poorer clinical outcomes in some studies. Previous studies have been plagued by methodologic problems, including small sample sizes, few clinical events, and uncontrolled confounders, particularly perioperative complications. In addition, few studies have examined social support as a potential protective factor. We therefore examined the association between pretransplant depressive symptoms, social support, and mortality in a large sample of lung transplant recipients. As a secondary aim, we also examined the associations between psychosocial factors, perioperative outcomes [indexed by hospital length of stay (LOS)], and mortality. We hypothesized that depression would be associated with longer LOS and that the association between depression, social support, and mortality would be moderated by LOS. Participants included lung transplant recipients, transplanted at Duke University Medical Center from January 2009 to December 2014. Depressive symptoms were evaluated using the Beck Depression Inventory (BDI-II) and social support using the Perceived Social Support Scale (PSSS). Medical risk factors included forced vital capacity (FVC), partial pressure of carbon dioxide (PCO 2 ), donor age, acute rejection, and transplant type. Functional status was assessed using six-minute walk distance (6MWD). We also controlled for demographic factors, including age, gender, and native disease. Transplant hospitalization LOS was examined as a marker of perioperative clinical outcomes. Participants included 273 lung recipients (174 restrictive, 67 obstructive, 26 cystic fibrosis, and six "other"). Pretransplant depressive symptoms were common, with 56 participants (21%) exhibiting clinically elevated levels (BDI-II ≥ 14). Greater depressive symptoms were associated with longer LOS [adjusted b = 0.20 (2 days per 7-point higher BDI-II score), P social support (P social support were

Greater temperature sensitivity of plant phenology at colder sites

DEFF Research Database (Denmark)

Prevey, Janet; Vellend, Mark; Ruger, Nadja

2017-01-01

Warmer temperatures are accelerating the phenology of organisms around the world. Temperature sensitivity of phenology might be greater in colder, higher latitude sites than in warmer regions, in part because small changes in temperature constitute greater relative changes in thermal balance...

Positive interaction of social comparison and personal responsibility for outcomes.

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Grygolec, Jaroslaw; Coricelli, Giorgio; Rustichini, Aldo

2012-01-01

We formulate and test a model that allows sharp separation between two different ways in which environment affects evaluation of outcomes, by comparing social vs. private and personal responsibility vs. chance. In the experiment, subjects chose between two lotteries, one low-risk and one high-risk. They could then observe the outcomes. By varying the environment between private (they could observe the outcome of the chosen lottery and the outcome of the lottery they had not chosen) and social (they could observe the outcome of the lottery chosen by another subject) we can differentiate the response and brain activity following the feedback in social and private settings. The evidence suggests that envy and pride are significant motives driving decisions and outcomes evaluation, stronger than private emotions like regret and rejoice, with ventral striatum playing a key role. When we focus on the outcome evaluation stage we demonstrate that BOLD signal in ventral striatum is increasing in the difference between obtained and counterfactual payoffs. For a given difference in payoffs, striatal responses are more pronounced in social than in private environment. Moreover, a positive interaction (complementarity) between social comparison and personal responsibility is reflected in the pattern of activity in the ventral striatum. At decision stage we observe getting ahead of the Joneses effect in ventral striatum with subjective value of risk larger in social than in private environment.

Creation, Identity and Reflection

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Alina Beatrice Cheşcă

2015-05-01

Full Text Available The paper “Creation, Identity and Reflection” approaches the identification in the “mirror” of reality with creation, in other words seeking the authors’ identity in the reflected images. Reflection means attempting to find oneself, the mirror being the main principle of creation. Many characters become interesting only when they step into the world beyond the mirror, when their faces are doubled by the other self or when their selves are returned by other characters. The narcissistic concept of the mirror, i.e. the reflection in the mirror and the representation of the mirror itself, is a recurrent one in literature, but the reflection of the self which is not the self (as it is a reflection does not necessarily appear in a mirror or in a photograph or portrait. Sometimes, the not-self is returned to the self by another person or character. As far as Oscar Wilde’s theories are concerned, the main idea is that people are interesting for their masks, not for their inner nature. What Wilde calls “inner nature” is the characters’ un-reflected self and the mask is the reflection, the self in the mirror. Some characters’ relationships develop within a fiction that they dramatically try to preserve and protect with the risk of suffering. They refuse to take off the masks which define them in the others’ minds and hearts; the narcissistic individuals (both artists and characters seek and love their own image which they project upon facts, thus creating a fictive realm.

Therapist facilitative interpersonal skills and training status: A randomized clinical trial on alliance and outcome.

Science.gov (United States)

Anderson, Timothy; Crowley, Mary Ellen J; Himawan, Lina; Holmberg, Jennifer K; Uhlin, Brian D

2016-09-01

Therapist effects, independent of the treatment provided, have emerged as a contributor to psychotherapy outcomes. However, past research largely has not identified which therapist factors might be contributing to these effects, though research on psychotherapy implicates relational characteristics. The present Randomized Clinical Trial tested the efficacy of therapists who were selected by their facilitative interpersonal skills (FIS) and training status. Sixty-five clients were selected from 2713 undergraduates using a screening and clinical interview procedure. Twenty-three therapists met with 2 clients for 7 sessions and 20 participants served in a no-treatment control group. Outcome and alliance differences for Training Status were negligible. High FIS therapists had greater pre-post client outcome, and higher rates of change across sessions, than low FIS therapists. All clients treated by therapists improved more than the silent control, but effects were greater with high FIS than low FIS therapists. From the first session, high FIS therapists also had higher alliances than low FIS therapists as well as significant improvements on client-rated alliance. Results were consistent with the hypothesis that therapists' common relational skills are independent contributors to therapeutic alliance and outcome.

Greater Somalia, the never-ending dream?

DEFF Research Database (Denmark)

Zoppi, Marco

2015-01-01

This paper provides an historical analysis of the concept of Greater Somalia, the nationalist project that advocates the political union of all Somali-speaking people, including those inhabiting areas in current Djibouti, Ethiopia and Kenya. The Somali territorial unification project of “lost...

Abstract "why" Thoughts About Success Lead to Greater Positive Generalization in Sport Participants.

Science.gov (United States)

Van Lier, Jens; Moulds, Michelle L; Raes, Filip

2015-01-01

Generalizing from a single failure or success to future performances and their self-concept could have an important impact on sport participants. This study examined the impact of the way sport participants think about success on positive generalization. Sport participants (N = 222) completed an online experimental study in which they were induced to think about meanings, causes and implications (i.e., abstract-"why"-thinking) or about more perceptual concrete aspects of their performance (i.e., concrete-"how"-thinking). We hypothesized that abstract-"why"-thinking would lead to greater positive generalization and that this effect would be moderated by self-esteem. Our results supported our hypothesis that abstract thinking increased positive generalization, and this effect was more clearly visible in sport participants with higher self-esteem. These results suggest that retrospective thinking about the "why" of a good performance may benefit athletes in the long run because they generalize the outcome to future performances and their self-concept which may boost their motivation and consequently their performance.

Endoscopic submucosal dissection in Spain: outcomes and development possibilities

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Juan J. Vila

2013-10-01

Full Text Available Endoscopic submucosal dissection (ESD allows endoscopic, curative, en-bloc resection of superficial malignant or premalignant lesions. This procedure was conceived over 10 years ago in Japan, but has not experienced great expansion in Western countries for different reasons. This article reviews ESD indications and outcomes, and reflects on the reasons that prevent ESD from becoming common clinical practice in Western hospitals. Finally, recommendations on ESD training in our setting are made.

Assessing Human Impacts on the Greater Akaki River, Ethiopia ...

African Journals Online (AJOL)

We assessed the impacts of human activities on the Greater Akaki River using physicochemical parameters and macroinvertebrate metrics. Physicochemical samples and macroinvertebrates were collected bimonthly from eight sites established on the Greater Akaki River from February 2006 to April 2006. Eleven metrics ...

Behavioural Outcome in Children with Congenital Adrenal Hyperplasia: Experience of a Single Centre

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Arini Nuran Idris

2014-01-01

Full Text Available The aim of this study was to determine the behavioral outcome in children with CAH and to identify the risk factors that may influence it. Participants (aged 6–18 years included 29 girls and 20 boys with CAH and unaffected siblings (25 girls and 17 boys. Psychological adjustment was assessed with parent reports on the Child Behavior Checklist (CBCL. Information about disease characteristics was obtained from medical records. Our study reveals that there was higher incidence of parent-reported problem of anxious/depressed and withdrawn/depressed behaviours, somatic complaints, social, thought, and attention problems, and rule-breaking, aggressive, internalizing, and externalizing behaviour among children with CAH compared to controls. The prevalence of internalizing behaviour problems was higher in CAH boys compared with that of controls. Psychosocial adjustment of girls with CAH was found to be similar to unaffected female controls and was within the normal population range. Family income may be associated with behavioral outcome. Glucocorticoid dose may reflect disease severity which may be associated with behavioral outcome. We conclude that internalizing behavioral problem was prevalent among boys with CAH reflecting maladaptive adjustment in coping with chronic illness. This highlighted the importance of psychological and social support for the patients and their families.

Assessment of pepper spray product potency in Asian and Caucasian forearm skin using transepidermal water loss, skin temperature and reflectance colorimetry.

Science.gov (United States)

Pershing, Lynn K; Reilly, Christopher A; Corlett, Judy L; Crouch, Dennis J

2006-01-01

Historically, pepper spray product potency has been established using a taste test evaluation. A taste test is subjective and may not be appropriate for assessing pepper potency in skin. The current study evaluated chemically diverse pepper sprays in human forearm skin using three objective, noninvasive parameters: transepidermal water loss, skin surface temperature and erythema, as a means for assessing dermal pharmacology, toxicology and product potency. Five commercial pepper spray products containing various capsaicinoid analogs at various concentrations were evaluated in duplicate on volar forearms of six Caucasians and six Asians using a 10 min exposure. Mean surface skin temperature, transepidermal water loss results were highly variable and therefore did not demonstrate dose responsive behavior to increasing capsaicinoid concentrations. Erythema, as measured by increases in a* (reflected light in the red-to-green color spectrum) of the L*a*b* uniform color scale, was superior among parameters evaluated in discriminating pepper spray potency and correlated well with the relative and total capsaicinoid concentration in the products. Products containing greater than 16 mg ml(-1) capsaicinoid concentration produced greater erythema responses in Caucasians than Asians. Asians responded greater to the synthetic analog, nonivamide, than to mixtures of capsaicinoids, while Caucasians responded equally to both capsaicinoid analogs. Thus, pepper spray product potency in human skin reflects the total capsaicinoid concentration, the specific capsaicin analog(s) present, and the race of the individual exposed. The finding that the reflectance colorimeter a* scale can differentiate these parameters in skin will have a significant impact on evaluating the use and efficacy of pepper spray products in humans. 2005 John Wiley & Sons, Ltd.

Outcome Determinants of Stroke in a Brazilian Primary Stroke Center

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Gustavo W. Kuster

2014-01-01

Full Text Available Background. Stroke mortality in Brazil is one of the highest among Western countries. Nonetheless, stroke outcome determinants are still poorly known in this country. In this study we evaluate outcome determinants of stroke in a primary stroke center in São Paulo, Brazil. Methods. We evaluated demographic, clinical, and outcome data of patients with ischemic stroke (IS, transient ischemic attack (TIA, and intracerebral hemorrhage (ICH admitted at “Hospital Paulistano,” São Paulo, Brazil. In-hospital mortality and functional outcome determinants were assessed. Univariate and binary logistic regression analysis were performed. Results. Three hundred forty-one patients were included in the study, 52.2% being male with 66.8±15.7 years. The stroke type distribution was IS: 59.2%, TIA: 29.6%, and ICH: 11.1%. ICH was associated with greater severity and poorer functional outcome. The determinants of poorer functional outcome were higher NIHSS, lower Glasgow score, and lower oxygen saturation level. The most important mortality determinant was the presence of visual symptoms. Conclusions. The stroke mortality and stroke outcome determinants found in the present study do not remarkably differ from studies carried out in developed countries. Stroke prognosis studies are crucial to better understand the high burden of stroke in Brazil.

Molecular insights into the biology of Greater Sage-Grouse

Science.gov (United States)

Oyler-McCance, Sara J.; Quinn, Thomas W.

2011-01-01

Recent research on Greater Sage-Grouse (Centrocercus urophasianus) genetics has revealed some important findings. First, multiple paternity in broods is more prevalent than previously thought, and leks do not comprise kin groups. Second, the Greater Sage-Grouse is genetically distinct from the congeneric Gunnison sage-grouse (C. minimus). Third, the Lyon-Mono population in the Mono Basin, spanning the border between Nevada and California, has unique genetic characteristics. Fourth, the previous delineation of western (C. u. phaios) and eastern Greater Sage-Grouse (C. u. urophasianus) is not supported genetically. Fifth, two isolated populations in Washington show indications that genetic diversity has been lost due to population declines and isolation. This chapter examines the use of molecular genetics to understand the biology of Greater Sage-Grouse for the conservation and management of this species and put it into the context of avian ecology based on selected molecular studies.

Myomas and Adenomyosis: Impact on Reproductive Outcome.

Science.gov (United States)

Vlahos, Nikos F; Theodoridis, Theodoros D; Partsinevelos, George A

2017-01-01

Among uterine structural abnormalities, myomas and adenomyosis represent two distinct, though frequently coexistent entities, with a remarkable prevalence in women of reproductive age. Various mechanisms have been proposed to explain the impact of each of them on reproductive outcome. In respect to myomas, current evidence implies that submucosal ones have an adverse effect on conception and early pregnancy. A similar effect yet is not quite clear and has been suggested for intramural myomas. Still, it seems reasonable that intramural myomas greater than 4 cm in diameter may negatively impair reproductive outcome. On the contrary, subserosal myomas do not seem to have a significant impact, if any, on reproduction. The presence of submucosal and/or large intramural myomas has also been linked to adverse pregnancy outcomes. In particular increased risk for miscarriage, fetal malpresentation, placenta previa, preterm birth, placenta abruption, postpartum hemorrhage, and cesarean section has been reported. With regard to adenomyosis, besides the tentative coexistence of adenomyosis and infertility, to date a causal relationship among these conditions has not been fully confirmed. Preterm birth and preterm premature rupture of membranes, uterine rupture, postpartum hemorrhage due to uterine atony, and ectopic pregnancy have all been reported in association with adenomyosis. Further research on the impact of adenomyosis on reproductive outcome is welcome.

The significance of ethics reflection groups in mental health care: a focus group study among health care professionals.

Science.gov (United States)

Hem, Marit Helene; Molewijk, Bert; Gjerberg, Elisabeth; Lillemoen, Lillian; Pedersen, Reidar

2018-06-05

Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of 'bricolage' which means our approach was inductive. Most participants report positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices.

Comparison of Ear-Canal Reflectance and Umbo Velocity in Patients with Conductive Hearing Loss

Science.gov (United States)

Merchant, Gabrielle R.; Nakajima, Hideko H.; Pisano, Dominic V.; Röösli, Christof; Hamade, Mohamad A.; Mafoud, Lorice; Halpin, Christopher F.; Merchant, Saumil N.; Rosowski, John J.

2011-11-01

Patients who present at hearing clinics with a conductive hearing loss (CHL) in the presence of an intact, healthy tympanic membrane create a unique challenge for otologists. While patient counseling, treatment options, and outcome vary with differing middle-ear pathologies, a non-invasive diagnostic that can differentiate between these pathologies does not currently exist. We evaluated the clinical utility and diagnostic accuracy of two non-invasive measures of middle-ear mechanics: ear-canal reflectance (ECR) and umbo velocity (VU).

Influence of median surgeon operative duration on adverse outcomes in bariatric surgery.

Science.gov (United States)

Reames, Bradley N; Bacal, Daniel; Krell, Robert W; Birkmeyer, John D; Birkmeyer, Nancy J O; Finks, Jonathan F

2015-01-01

Evidence suggests that prolonged operative time adversely affects surgical outcomes. However, whether faster surgeons have better outcomes is unclear, as a surgeon׳s speed could reflect skill and efficiency, but may alternatively reflect haste. This study evaluates whether median surgeon operative time is associated with adverse surgical outcomes after laparoscopic Roux-en-Y gastric bypass. We performed a retrospective cohort study using statewide clinical registry data from the years 2006 to 2012. Surgeons were ranked by their median operative time and grouped into terciles. Multivariable logistic regression with robust standard errors was used to evaluate the influence of median surgeon operative time on 30-day surgical outcomes, adjusting for patient and surgeon characteristics, trainee involvement, concurrent procedures, and the complex interaction between these variables. A total of 16,344 patients underwent surgery during the study period. Compared to surgeons in the fastest tercile, slow surgeons required 53 additional minutes to complete a gastric bypass procedure (median [interquartile range] 139 [133-150] versus 86 [69-91], Ppatient characteristic only, slow surgeons had significantly higher adjusted rates of any complication, prolonged length of stay, emergency department visits or readmissions, and venous thromboembolism (VTE). After further adjustment for surgeon characteristics, resident involvement, and the interaction between these variables, slow surgeons had higher rates of any complication (10.5% versus 7.1%, P=.039), prolonged length of stay (14.0% versus 4.4%, P=.002), and VTE (0.39% versus .22%, P<.001). Median surgeon operative duration is independently associated with adjusted rates of certain adverse outcomes after laparoscopic Roux-en-Y gastric bypass. Improving surgeon efficiency while operating may reduce operative time and improve the safety of bariatric surgery. Copyright © 2015 American Society for Bariatric Surgery. Published by

Accelerated decay rates drive soil organic matter persistence and storage in temperate forests via greater mineral stabilization of microbial residues.

Science.gov (United States)

Phillips, R.; Craig, M.; Turner, B. L.; Liang, C.

2017-12-01

Climate predicts soil organic matter (SOM) stocks at the global scale, yet controls on SOM stocks at finer spatial scales are still debated. A current hypothesis predicts that carbon (C) and nitrogen (N) storage in soils should be greater when decomposition is slow owing to microbial competition for nutrients or the recalcitrance of organic substrates (hereafter the `slow decay' hypothesis). An alternative hypothesis predicts that soil C and N storage should be greater in soils with rapid decomposition, owing to the accelerated production of microbial residues and their stabilization on soil minerals (hereafter the `stabilization hypothesis'). To test these alternative hypotheses, we quantified soil C and N to 1-m depth in temperate forests across the Eastern and Midwestern US that varied in their biotic, climatic, and edaphic properties. At each site, we sampled (1) soils dominated by arbuscular mycorrhizal (AM) tree species, which typically have fast decay rates and accelerated N cycling, (2) soils dominated by ectomycorrhizal (ECM) tree species, which generally have slow decay rates and slow N cycling, and (3) soils supporting both AM and ECM trees. To the extent that trees and theor associated microbes reflect and reinforce soil conditions, support for the slow decay hypothesis would be greater SOM storage in ECM soils, whereas support for the stabilization hypothesis would be greater SOM storage in AM soils. We found support for both hypotheses, as slow decomposition in ECM soils increased C and N storage in topsoil, whereas fast decomposition in AM soils increased C and N storage in subsoil. However, at all sites we found 57% greater total C and N storage in the entire profile in AM- soils (P stabilization hypothesis. Amino sugar biomarkers (an indicator of microbial necromass) and particle size fractionation revealed that the greater SOM storage in AM soils was driven by an accumulation of microbial residues on clay minerals and metal oxides. Taken together

Social Engineering Attacks and Countermeasures in the New Zealand Banking System: Advancing a User-Reflective Mitigation Model

Directory of Open Access Journals (Sweden)

David Airehrour

2018-05-01